Screening recipients of increased-risk donor organs: a survey of transplant infectious diseases physician practices

Transpl Infect Dis. 2013 Oct;15(5):545-9. doi: 10.1111/tid.12121. Epub 2013 Jul 31.

Abstract

Background: In 1994, the Public Health Service published guidelines to minimize the risk of human immunodeficiency virus (HIV) transmission and to monitor recipients following the transplantation of organs from increased-risk donors. A 2007 survey revealed the post-transplant surveillance of recipients of organs from increased-risk donors (ROIRD) is variable.

Methods: An electronic survey was sent to transplant infectious diseases physicians at US solid organ transplant centers.

Results: A total of 126 surveys were sent to infectious diseases physicians, and we received 51 (40%) responses. We found that 22% of respondents obtain only verbal, 69% verbal and written, and 8% do not obtain any special consent from ROIRD, despite an Organ Procurement and Transplantation Network policy requiring such consent. Post-solid organ transplantation serologies for HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) are performed by 6-8% of respondents in all recipients, by 69% of respondents in ROIRD only, and 25% of respondents do not perform them at all. Post-transplant nucleic acid testing is carried out by 55-64% of respondents in ROIRD, by 0-2% in all recipients, and not performed by 35-43% of respondents.

Conclusion: Screening RIORD for HIV, HBV, and HCV has increased since 2007, but remains less than optimal and is incomplete when screening for disease transmission at many centers.

Keywords: HIV; OPTN-defined increased-risk donors; hepatitis B; hepatitis C; organ recipients; screening.

MeSH terms

  • Female
  • HIV / immunology
  • HIV / isolation & purification*
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • Hepacivirus / immunology
  • Hepacivirus / isolation & purification*
  • Hepatitis B / prevention & control*
  • Hepatitis B / transmission
  • Hepatitis B virus / immunology
  • Hepatitis B virus / isolation & purification*
  • Hepatitis C / prevention & control*
  • Hepatitis C / transmission
  • Humans
  • Risk
  • Tissue Donors
  • Tissue and Organ Procurement
  • United States