TABLE 1.
Baseline characteristics of (a) deceased organ donors and (b) solid organ transplant recipients stratified by donor history of recent injection drug use (IDU)
| (a) Deceased organ donors (N = 394) | |||
|---|---|---|---|
| Baseline characteristica,b |
Donor with history of recent IDU(N = 66) |
Donor with no history of recent IDU (N = 328) |
p-Value |
| Demographics | |||
| Age (median, IQR), years | 30 (25-34) | 43 (27-54) | <.01 |
| Female gender | 24 (36%) | 140 (43%) | .34 |
| Race: Black | 1 (2%) | 53 (16%) | .01 |
| Race: White | 63 (95%) | 232 (71%) | <.01 |
| Ethnicity: Hispanic | 2 (3%) | 33 (10%) | .09 |
| Comorbidities | |||
| Diabetes mellitus | 1 (2%) | 43 (13%) | .01 |
| Hypertension | 1 (2%) | 43 (13%) | .01 |
| Active marijuana use | 16 (24%) | 56 (17%) | .17 |
| Death mechanism | |||
| Drug overdose | 48 (73%) | 31 (9%) | <.01 |
| Asphyxiation | 1 (2%) | 22 (7%) | .15 |
| Cardiovascular | 6 (9%) | 95 (29%) | .01 |
| Gunshot wound | 3 (5%) | 25 (8%) | .60 |
| Blunt injury | 4 (6%) | 51 (16%) | .05 |
| Intracranial hemorrhage | 4 (6%) | 96 (29%) | <.01 |
| Donor type | |||
| Donation after circulatory death | 4 (6%) | 96 (29%) | <.01 |
| Expanded criteria donor | 1 (2%) | 73 (22%) | <.01 |
| PHS-increased riskc,d | 65 (98%) | 66 (20%) | <.01 |
| Kidney donor profile index, median (IQR) | 24 (8-43) | 51 (23-79) | <.01 |
| Laboratory values | |||
| CMV seropositive | 24 (36%) | 178 (54%) | .01 |
| EBV seropositive | 66 (100%) | 297 (91%) | .01 |
| HCV seropositive | 14 (21%) | 9 (3%) | <.01 |
| HBsAg positive | 0 (0%) | 1 (0%) | >.99 |
| HBcAb positive | 0 (0%) | 15 (5%) | .09 |
| Donor management | |||
| Length of stay during terminal hospitalization (median, IQR), days | 4 (2-5) | 3 (2-5) | .18 |
| Antimicrobial administration during terminal hospitalization | 66 (100%) | 316 (97%) | .22 |
| (b) Solid organ transplant recipients (N=658) | |||
| Baseline characteristica,b |
Donor with history of recent IDU(N = 120) |
Donor with no history of recent IDU (N = 538) |
p-Value |
| Demographics | |||
| Age (median, IQR), years | 56 (45-63) | 60 (49-66) | .01 |
| Female gender | 35 (29%) | 196 (36%) | .13 |
| Race: White | 69 (58%) | 319 (59%) | .72 |
| Race: Black | 44 (37%) | 168 (31%) | .25 |
| Race: Asian | 4 (3%) | 17 (3%) | >.99 |
| Ethnicity: Hispanic | 12 (10%) | 36 (7%) | .21 |
| Organ transplant type | |||
| Kidney | 52 (43%) | 195 (36%) | .31 |
| Liver | 29 (24%) | 145 (27%) | .31 |
| Pancreas | 2 (2%) | 3 (1%) | .31 |
| Heart | 18 (15%) | 83 (15%) | .31 |
| Lung | 19 (16%) | 112 (21%) | .31 |
| Comorbidities | |||
| Uncomplicated diabetes mellitus | 14 (12%) | 91 (17%) | .16 |
| Complicated diabetes mellitus | 28 (23%) | 81 (15%) | .03 |
| Hypertension | 72 (60%) | 331 (62%) | .76 |
| Chronic kidney disease | 35 (29%) | 129 (24%) | .24 |
| Cirrhosis | 28 (23%) | 138 (26%) | .60 |
| Congestive heart failure | 29 (24%) | 114 (21%) | .48 |
| Prior solid organ Transplant | 10 (8%) | 18 (3%) | .01 |
| Charlson comorbidity index (median, IQR) | 4 (2–6) | 4 (2–6) | .57 |
| Pretransplant characteristics | |||
| Days on waitlist (median, IQR) | 187 (39–640) | 236 (51–783) | .55 |
| Intensive care unit pretransplantatione | 9 (8%) | 51 (9%) | .50 |
| Mechanical ventilation pretransplantatione | 2 (2%) | 16 (3%) | .55 |
| Renal replacement therapy pretransplantatione | 60 (50%) | 202 (38%) | .02 |
| Laboratory Values | |||
| CMV seropositive | 65 (54%) | 310 (58%) | .49 |
| EBV seropositive | 109 (91%) | 512 (95%) | .06 |
| HCV seropositive | 22 (23%) | 49 (13%) | .01 |
| HBsAg positive | 2 (2%) | 6 (1%) | .65 |
| HBcAb positive | 12 (10%) | 66 (12%) | .48 |
Abbreviations: CMV, cytomegalovirus; EBV, Epstein Barr virus; HBsAg, hepatitis B surface antigen; HBcAb, hepatitis B core antibody; HCV, hepatitis C virus; IDU, injection drug use; IQR, interquartile range; MDRO, multidrug-resistant organism; PHS, Public Health Service.
Data are presented as numbers (percentages) except where noted.
Only those variables with a p value <.20, those of notable biologic importance, and those included in the final multivariable models are shown in this table.
PHS has since adopted the use of “risk criteria” for infection transmission in place of the term “increased risk donor.” These data were collected prior to this terminology change.
One donor with a history of IDU in the prior 12 months was not classified as being an “increased risk donor,” likely because the history from next-of-kin/donor informant was ambiguous about exactly when the IDU ended and estimated it was “about a year ago.”
Assessed in the 24 h prior to transplantation.