Outcome of Transplantation of Organs Procured From Bacteremic Donors1

Abstract

Organs transplanted from bacteremic donors do not transmit bacterial infection or result in poorer outcomes. Use of organs from these donors could help increase organ availability.

Impact of donor bacteremia on outcome in organ transplant recipients

“…4 Two recent studies comprising a large number of patients have shown that donor bacteremia did not portend a higher risk of infectious complications or compromise graft or patient survival. 1,2 The most frequent cause of the donor bacteremias in these studies was gram-positive bacteria, of which S. aureus was the predominant pathogen. A vast majority of the recipients of organs retrieved from bacteremic donors in the aforementioned studies had received antimicrobial therapy.…”

“…In the report by Freeman et al, 91% of the recipients had received antibiotics for a mean of 3.8 days. 2 These data suggest that with appropriately administered antibiotic therapy, organs from bacteremic donors can be successfully transplanted without incurring an additional risk for infection or allograft dysfunction in the recipient.…”

“…2 The results of blood cultures in the donor may therefore frequently be unavailable at the time of harvesting of the organs. When characteristics of donors who were ultimately found to be bacteremic were compared with those without bacteremia, only fever in the 24 hours before harvesting was significantly predictive of bacteremia in the donor.…”

Medical management to optimize donor organ potential: review of the literature

“…[128][129][130][131] However, by using prophylactic antibiotics in recipients immediately after transplantation, two studies totaling 124 organ recipients have demonstrated no transmission of bacterial infection from bacteremic donors to organ recipients. 132,133 In an analysis of all organ donors cared for by the New England Organ bank between 1990 and 1996, only 95 (5.1%) of 1,775 organ donors were identified as being bacteremic. 133 No evidence of bacterial transmission could be identified in 212 recipients and there was no difference in allograft or recipient survival for recipients of organs from bacteremic as compared to non-bacteremic donors.…”

“…132,133 In an analysis of all organ donors cared for by the New England Organ bank between 1990 and 1996, only 95 (5.1%) of 1,775 organ donors were identified as being bacteremic. 133 No evidence of bacterial transmission could be identified in 212 recipients and there was no difference in allograft or recipient survival for recipients of organs from bacteremic as compared to non-bacteremic donors.…”