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. 2012 Apr 26;30:19–26. doi: 10.1016/S0213-005X(12)70078-2

Evaluating the risk of transmission of infection from donor to recipient of a solid organ transplantation

Evaluación del riesgo de transmisión de infección procedente del donante al receptor de un trasplante de órgano sólido

Óscar Len a,⁎, Antonio Ramos b, Albert Pahissa a
PMCID: PMC7130295  PMID: 22542031

Abstract

In the context of solid organ transplantation, screening of potential organ donors is crucial, and should be performed with great rigor to minimize the risk of transmission of certain infectious processes. This review aims to update understanding of the possible pathologies involved, as well as of emerging infections that, as a result of globalization, are gaining increasing prominence on a daily basis.

Keywords: Infection, Donor-to-host transmission, Transplantation

References

  • 1.Avery R.K., Ljungman P. Prophylactic measures in the solid-organ recipient before transplantation. Clin Infect Dis. 2001;33(Suppl 1):S15–S21. doi: 10.1086/320899. [DOI] [PubMed] [Google Scholar]
  • 2.Schaffner A. Pretransplant evaluation for infections in donors and recipients of solid organs. Clin Infect Dis. 2001;33(Suppl 1):S9–S14. doi: 10.1086/320898. [DOI] [PubMed] [Google Scholar]
  • 3.Criterios de selección del donante de órganos respecto a la transmisión de infecciones. Documento de consenso ONT-GESITRA. 2nd ed. 2004. Accessed at: http://www.seimc.org/grupos/gesitra/index.asp?apV=produccion&apV1=DyC&apnv0=DyC_txt.htm on Sept 11, 2011
  • 4.Fischer S.A., Avery R.K. Screening of donor and recipient prior to solid organ transplantation. Am J Transplant. 2009;9(Suppl 4):S7–S18. doi: 10.1111/j.1600-6143.2009.02888.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 5.Grossi P.A., Fishman J.A. Donor-derived infections in solid organ transplant recipients. Am J Transplant. 2009;9(Suppl 4):S19–S26. doi: 10.1111/j.1600-6143.2009.02889.x. [DOI] [PubMed] [Google Scholar]
  • 6.Delmonico F.L. Cadaver donor screening for infectious agents in solid organ transplantation. Clin Infect Dis. 2000;31:781–786. doi: 10.1086/314000. [DOI] [PubMed] [Google Scholar]
  • 7.Martin-Davila P., Fortun J., Lopez-Velez R., Norman F., Montes de Oca M., Zamarrón P. Transmission of tropical and geographically restricted infections during solid-organ transplantation. Clin Microbiol Rev. 2008;21:60–96. doi: 10.1128/CMR.00021-07. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Directive 2010/45/EU of the European Parliament and of the Council of 7 July 2010 on standards of quality and safety of human organs intended for transplantation. Accessed at: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX: 32010L0045(01):EN:HTML on September 11, 2011.
  • 9.Iwamoto M., Jernigan D.B., Guasch A., Trepka M.J., Blackmore C.G., Hellinger W.C. Transmission of West Nile virus from an organ donor to four transplant recipients. N Engl J Med. 2003;348:2196–2203. doi: 10.1056/NEJMoa022987. [DOI] [PubMed] [Google Scholar]
  • 10.Danziger-Isakov L.A., Husain S., Mooney M.L., Hannan M.M. The novel 2009 H1N1 influenza virus pandemic: unique considerations for programs in cardiothoracic transplantation. J Heart Lung Transplant. 2009;28:1341–1347. doi: 10.1016/j.healun.2009.10.001. [DOI] [PubMed] [Google Scholar]
  • 11.Kumar D., Tellier R., Draker R., Levy G., Humar A. Severe Acute Respiratory Syndrome (SARS) in a liver transplant recipient and guidelines for donor SARS screening. Am J Transplant. 2003;3:977–981. doi: 10.1034/j.1600-6143.2003.00197.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Simonds R.J., Holmberg S.D., Hurwitz R.L., Coleman T.R., Bottenfield S., Conley L.J. Transmission of human immunodeficiency virus type 1 from a seronegative organ and tissue donor. N Engl J Med. 1992;326:726–732. doi: 10.1056/NEJM199203123261102. [DOI] [PubMed] [Google Scholar]
  • 13.Muller E., Kahn D., Mendelson M. Renal transplantation between HIV-positive donors and recipients. N Engl J Med. 2010;362:2336–2337. doi: 10.1056/NEJMc0900837. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Yao F., Seed C., Farrugia A., Morgan D., Cordner S., Wood D. The risk of HIV, HBV, HCV and HTLV infection among musculoskeletal tissue donors in Australia. Am J Transplant. 2007;7:2723–2726. doi: 10.1111/j.1600-6143.2007.02012.x. [DOI] [PubMed] [Google Scholar]
  • 15.Levitsky J., Doucette K. Viral hepatitis in solid organ transplant recipients. Am J Transplant. 2009;9(Suppl 4):S116–S130. doi: 10.1111/j.1600-6143.2009.02902.x. [DOI] [PubMed] [Google Scholar]
  • 16.Chung R.T., Feng S., Delmonico F.L. Approach to the managment of allograft recipients following the detection of hepatitis B virus in the prospective organ donor. Am J Transplant. 2001;1:185–191. [PubMed] [Google Scholar]
  • 17.Madayag R.M., Johnson L.B., Bartlett S.T., Schweitzer E.J., Constantine N.T., McCarter R.J., Jr. Use of renal allografts from donors positive for hepatitis B core antibody confers minimal risk for subsequent development of clinical hepatitis B virus disease. Transplantation. 1997;64:1781–1786. doi: 10.1097/00007890-199712270-00027. [DOI] [PubMed] [Google Scholar]
  • 18.Pereira B.J., Wright T.L., Schmid C.H., Levey A.S. A controlled study of hepatitis C transmission by organ transplantation. The New England Organ Bank Hepatitis C Study Group. Lancet. 1995;345:484–487. doi: 10.1016/s0140-6736(95)90583-9. [DOI] [PubMed] [Google Scholar]
  • 19.Ong J.P., Barnes D.S., Younossi Z.M., Gramlich T., Yen-Lieberman B., Goormastic M. Outcome of de novo hepatitis C virus infection in heart transplant recipients. Hepatology. 1999;30:1293–1298. doi: 10.1002/hep.510300519. [DOI] [PubMed] [Google Scholar]
  • 20.Pfau P.R., Rho R., DeNofrio D., Loh E., Blumberg E.A., Acker M.A. Hepatitis C transmission and infection by orthotopic heart transplantation. J Heart Lung Transplant. 2000;19:350–354. doi: 10.1016/s1053-2498(00)00062-0. [DOI] [PubMed] [Google Scholar]
  • 21.Rosengard B.R., Feng S., Alfrey E.J., Zaroff J.G., Emond J.C., Henry M.L. Report of the Crystal City meeting to maximize the use of organs recovered from the cadaver donor. Am J Transplant. 2002;2:701–711. doi: 10.1034/j.1600-6143.2002.20804.x. [DOI] [PubMed] [Google Scholar]
  • 22.Tugwell B.D., Patel P.R., Williams I.T., Hedberg K., Chai F., Nainan O.V. Transmission of hepatitis C to several organ and tissue recipients from an antibody-negative donor. Ann Intern Med. 2005;143:648–654. doi: 10.7326/0003-4819-143-9-200511010-00008. [DOI] [PubMed] [Google Scholar]
  • 23.Ahn J., Cohen S.M. Transmission of human immunodeficiency virus and hepatitis C virus through liver transplantation. Liver Transpl. 2008;14:1603–1608. doi: 10.1002/lt.21534. [DOI] [PubMed] [Google Scholar]
  • 24.Torre-Cisneros J., Fariñas M.A., Castón J.J., Aguado J.M., Cantisán S., Carratalà J. GESITRA-SEIMC/REIPI recommendations for the management of cytomegalovirus infection in solid-organ transplant patients. Enferm Infecc Microbiol Clin. 2011;29:735–758. doi: 10.1016/j.eimc.2011.05.022. [DOI] [PubMed] [Google Scholar]
  • 25.Cortes N.J., Afzali B., MacLean D., Goldsmith D.J., O'Sullivan H., Bingham J. Transmission of syphilis by solid organ transplantation. Am J Transplant. 2006;6:2497–2499. doi: 10.1111/j.1600-6143.2006.01461.x. [DOI] [PubMed] [Google Scholar]
  • 26.Ridgeway A.L., Warner G.S., Phillips P., Forshag M.S., McGiffin D.C., Harden J.W. Transmission of Mycobacterium tuberculosis to recipients of single lung transplants from the same donor. Am J Respir Crit Care Med. 1996;153:1166–1168. doi: 10.1164/ajrccm.153.3.8630561. [DOI] [PubMed] [Google Scholar]
  • 27.Torre-Cisneros J., Doblas A., Aguado J.M., San Juan R., Blanes M., Montejo M. Tuberculosis after solid-organ transplant: incidence, risk factors and clinical characteristics in the RESITRA (Spanish Network of Infection in Transplantation) cohort. Clin Infect Dis. 2009;48:1657–1665. doi: 10.1086/599035. [DOI] [PubMed] [Google Scholar]
  • 28.Aguado J.M., Torre-Cisneros J., Fortún J., Benito N., Meije Y., Doblas A. Tuberculosis in solid-organ transplant recipients: consensus statement of the group for the study of infection in transplant recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology. Clin Infect Dis. 2009;48:1276–1284. doi: 10.1086/597590. [DOI] [PubMed] [Google Scholar]
  • 29.Freeman R.B., Giatras I., Falagas M.E., Supran S., O’Connor K., Bradley J. Outcome of transplantation of organs procured from bacteremic donors. Transplantation. 1999;68:1107–1111. doi: 10.1097/00007890-199910270-00008. [DOI] [PubMed] [Google Scholar]
  • 30.Len O., Gavaldá J., Blanes M., Montejo M., San Juan R., Moreno A. Donor infection and transmission to the recipient of a solid allograft. Am J Transplant. 2008;8:2420–2425. doi: 10.1111/j.1600-6143.2008.02397.x. [DOI] [PubMed] [Google Scholar]
  • 31.Coll P., Montserrat I., Ballester M., March F., Moya C., Obrador D. Epidemiologic evidence of transmission of donor-related bacterial infection through a transplanted heart. J Heart Lung Transplant. 1997;16:464–467. [PubMed] [Google Scholar]
  • 32.Dowling R.D., Baladi N., Zenati M., Dummer J.S., Kormos R.L., Armitage J.M. Disruption of the aortic anastomosis after heart-lung transplantation. Ann Thorac Surg. 1990;49:118–122. doi: 10.1016/0003-4975(90)90368-g. [DOI] [PubMed] [Google Scholar]
  • 33.Lumbreras C., Sanz F., González A., Pérez G., Ramos M.J., Aguado J.M. Clinical significance of donor-unrecognized bacteremia in the outcome of solid-organ transplant recipients. Clin Infect Dis. 2001;33:722–726. doi: 10.1086/322599. [DOI] [PubMed] [Google Scholar]
  • 34.Van Raemdonck D., Neyrinck A., Verleden G.M., Dupont L., Coosemans W., Decaluwé H. Lung donor selection and management. Proc Am Thorac Soc. 2009;6:28–38. doi: 10.1513/pats.200808-098GO. [DOI] [PubMed] [Google Scholar]
  • 35.Ruiz I., Gavaldá J., Monforte V., Len O., Román A., Bravo C. Donor-to-host transmission of bacterial and fungal infections in lung transplantation. Am J Transplant. 2006;6:178–182. doi: 10.1111/j.1600-6143.2005.01145.x. [DOI] [PubMed] [Google Scholar]
  • 36.Hill D., Dubey J.P. Toxoplasma gondii: transmission, diagnosis and prevention. Clin Microbiol Infect. 2002;8:634–640. doi: 10.1046/j.1469-0691.2002.00485.x. [DOI] [PubMed] [Google Scholar]
  • 37.Derouin F., Pelloux H. Prevention of toxoplasmosis in transplant patients. Clin Microbiol Infect. 2008;14:1089–1101. doi: 10.1111/j.1469-0691.2008.02091.x. [DOI] [PubMed] [Google Scholar]
  • 38.Gallino A., Maggiorini M., Kiowski W., Martin X., Wunderli W., Schneider J. Toxoplasmosis in heart transplant recipients. Eur J Clin Microbiol Infect Dis. 1996;15:389–393. doi: 10.1007/BF01690095. [DOI] [PubMed] [Google Scholar]
  • 39.Kotton C.N., Lattes R. Parasitic infections in solid organ transplant recipients. Am J Transplant. 2009;9(Suppl 4):S234–S251. doi: 10.1111/j.1600-6143.2009.02915.x. [DOI] [PubMed] [Google Scholar]
  • 40.Guidelines for preventing transmission of human immunodeficiency virus through transplantation of human tissue and organs. Centers for Disease Control and Prevention MMWR Recomm Rep. 1994;43(RR-8):1–17. [PubMed] [Google Scholar]
  • 41.Humar A., Morris M., Blumberg E., Freeman R., Preiksaitis J., Kiberd B. Nucleic acid testing (NAT) of organ donors: is the ‘best’ test the right test? A consensus conference report. Am J Transplant. 2010;10:889–899. doi: 10.1111/j.1600-6143.2009.02992.x. [DOI] [PubMed] [Google Scholar]
  • 42.Singer A.L., Kucirka L.M., Namuyinga R., Hanrahan C., Subramanian A.K., Segev D.L. The high-risk donor: viral infections in solid organ transplantation. Curr Opin Organ Transplant. 2008;13:400–404. doi: 10.1097/MOT.0b013e3283094ba3. [DOI] [PubMed] [Google Scholar]
  • 43.Assal A., Barlet V., Deschaseaux M., Dupont I., Gallian P., Guitton C. Sensitivity of two hepatitis B virus, hepatitis C virus (HCV), and human immunodeficiency virus (HIV) nucleic acid test systems relative to hepatitis B surface antigen, anti-HCV, anti-HIV, and p24/anti-HIV combination assays in seroconversion panels. Transfusion. 2009;49:301–310. doi: 10.1111/j.1537-2995.2008.01966.x. [DOI] [PubMed] [Google Scholar]
  • 44.Limaye A.P., Connolly P.A., Sagar M., Fritsche T.R., Cookson B.T., Wheat L.J. Transmission of Histoplasma capsulatum by organ transplantation. N Engl J Med. 2000;343:1163–1166. doi: 10.1056/NEJM200010193431605. [DOI] [PubMed] [Google Scholar]
  • 45.Miller M.B., Hendren R., Gilligan P.H. Posttransplantation disseminated coccidioidomycosis acquired from donor lungs. J Clin Microbiol. 2004;42:2347–2349. doi: 10.1128/JCM.42.5.2347-2349.2004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 46.Fischer L., Sterneck M., Claus M., Costard-Jäckle A., Fleischer B., Herbst H. Transmission of Malaria tertiana by multi-organ donation. Clin Transplant. 1999;13:491–495. doi: 10.1034/j.1399-0012.1999.130609.x. [DOI] [PubMed] [Google Scholar]
  • 47.Chagas disease after organ transplantation--Los Angeles. California, 2006 MMWR Morb Mortal Wkly Rep. 2006;55:798–800. [PubMed] [Google Scholar]
  • 48.Salvador F., Len O., Molina S., Sauleda S., Bilbao I., Castells L. Safety of liver transplantation performed with Chagas seropositive donors to seronegative recipients. Liver Transpl. 2011;17:1304–1308. doi: 10.1002/lt.22346. [DOI] [PubMed] [Google Scholar]
  • 49.Rodríguez-Hernández M.J., Ruiz-Perez-Pipaon M., Cañas E., Bernal C., Gavilán F. Strongyloides stercoralis hyperinfection transmitted by liver allograft in a transplant recipient. Am J Transplant. 2009;9:637–640. doi: 10.1111/j.1600-6143.2009.02828.x. [DOI] [PubMed] [Google Scholar]
  • 50.Shames B.D., D’Alessandro A.M., Sollinger H.W. Human T-cell lymphotrophic virus infection in organ donors: a need to reassess policy? Am J Transplant. 2002;2:658–663. doi: 10.1034/j.1600-6143.2002.20712.x. [DOI] [PubMed] [Google Scholar]
  • 51.Srinivasan A., Burton E.C., Kuehnert M.J., Rupprecht C., Sutker W.L., Ksiazek T.G. Transmission of rabies virus from an organ donor to four transplant recipients. N Engl J Med. 2005;352:1103–1111. doi: 10.1056/NEJMoa043018. [DOI] [PubMed] [Google Scholar]

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