Regarding unexpected severe and life-threatening donor-transmitted viral infections and use of high-risk behavior donors

Kusne, Shimon

doi:10.1002/lt.21633

Cited by 7 publications

(8 citation statements)

References 15 publications

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“…Furthermore, cross‐reactivity of WNV IgG is induced by other flaviviruses . Ultimately, in cases of encephalitis, it may be prudent to avoid the use of these donors, as described earlier; the use of donors with known WNV infections of the central nervous system is not advised because of the risk of recipient transmission …”

Section: Transmission Of Donor‐derived Infectious Diseases and Liver mentioning

confidence: 99%

“…74 Ultimately, in cases of encephalitis, it may be prudent to avoid the use of these donors, as described earlier; the use of donors with known WNV infections of the central nervous system is not advised because of the risk of recipient transmission. 69,70,[75][76][77] Epstein-Barr Virus EBV is of particular concern because of its association with posttransplant lymphoproliferative disorder, especially in the pediatric population. Donor and recipient screening should be performed, and there should be consideration of preemptive monitoring in high risk situations (i.e.…”

Section: West Nile Virusmentioning

confidence: 99%

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Update on donor-derived infections in liver transplantation

Echenique

Ison

2013

Liver Transpl

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Advances in surgical techniques, immunosuppressive medications, and robust infectious disease prophylaxis have resulted in liver transplantation becoming the treatment of choice for patients with end-stage liver disease and unresectable hepatocellular carcinoma. Nonetheless, organ transplantation is not without risk. Unexpected donor-derived disease transmission is a newly recognized risk that complicates approximately 0.2% of all organ transplants. We review the epidemiology of donor-derived infectious diseases and methods of risk mitigation with a focus on liver transplantation.

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Section: Transmission Of Donor‐derived Infectious Diseases and Liver mentioning

confidence: 99%

Section: West Nile Virusmentioning

confidence: 99%

Update on donor-derived infections in liver transplantation

Echenique

Ison

2013

Liver Transpl

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“…However, HTLV‐1 infects approximately 15–25 million people worldwide [3] and is associated with adult T‐cell leukemia/lymphoma (ATL), HTLV‐1‐associated myelopathy (HAM), uvetitis, sialadenitis‐like Sjögren syndrome (SjS), and a wide variety lymphocyte‐mediated disorders [2,4,5]. Severe and life‐threatening donor‐transmitted HTLV‐1 infections after solid organ transplantation have been reported [6–8]. However, in HTLV‐1‐infected recipients, graft and patient survival has not been fully evaluated.…”

Section: Introductionmentioning

confidence: 99%

“…Between 1988 and 2000, 0.027% of donors reporting to the United Network for Organ Sharing (UNOS) were diagnosed with HTLV‐1 infections [6]. However, the prevalence of anti‐HTLV‐1 antibodies in patients visiting Nagasaki University Hospital between 2000 and 2007 was 13.57% [2], indicating that HTLV‐1 carriers are clustered in Nagasaki.…”

Section: Introductionmentioning

confidence: 99%

Human T-cell leukemia virus type 1 infection worsens prognosis of hepatitis C virus-related living donor liver transplantation

Ichikawa

Taura

Miyaaki

et al. 2012

Transplant International

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Summary Severe and life‐threatening donor‐transmitted human T‐cell leukemia virus type 1 (HTLV‐1) infections after solid organ transplantation have been reported. However, in HTLV‐1‐infected recipients, graft and patient survival were not fully evaluated. A total of 140 patients underwent living donor liver transplantation (LDLT). Of these, 47 of 126 adult recipients showed indications of hepatitis C virus (HCV)‐related liver disease. The HTLV‐1 prevalence rate was 10 of 140 recipients (7.14%) and three of 140 donors (0.02%). In HCV‐related LDLT, graft and patient survival was worsened by HTLV‐1 infection in recipients (seven cases). The 1‐, 3‐, and 5‐year survival rates in the HCV/HTLV‐1‐co‐infected group were 67%, 32%, and 15%, respectively, and the corresponding rates in the HCV‐mono‐infected group were 80%, 67%, and 67%, respectively. Only the 5‐year survival rates were statistically significant (P = 0.04, log‐rank method). HTLV‐1 infection in recipients is also an important factor in predicting survival in HTLV‐1 endemic areas.

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“…This not only is an oversight in the article and in its accompanying editorial 1,3 but also is missing from most discussions on this topic. The guidelines clearly recommend that all recipients of organs from increased-risk donors "be tested for HIV immediately before transplantation and at 3 months following transplantation."…”

mentioning

confidence: 99%

Transmission of human immunodeficiency virus and hepatitis C virus through liver transplantation

Ison

Friedewald

2009

Liver Transpl

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TO THE EDITORS:We are writing in regard to a recently published article by Ahn and Cohen documenting the transmission of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) to a liver recipient, 2 kidney recipients, and 1 heart recipient. 1 The authors clearly present the case from their patients' perspective, allowing the transplant community to review many of the facts regarding their care. The authors state in the abstract and in the discussion that the transmission occurred secondary to the donor being within the window period between initial infection and detection of antibodies. This is factually incorrect because it has not been clearly confirmed and hemodilution may have contributed to the lack of detection. To date, confirmatory serologic and molecular testing has been conducted only on residual blood drawn on the donor post-transfusion. Because of legal proceedings, the pretransfusion blood has not had confirmatory serologic or molecular testing. Until this is done, it is impossible to determine whether the negative serologic testing that was reported to the centers at the time of the organ offer represented a true negative because the patient was in the window period or if the blood and fluids that the donor had received prior to specimen collection diluted the sample.Second, an important recommendation from the 1994 Public Health Services Guidelines is not included in the discussion 2 : the need for posttransplant testing of all recipients of organs from increased-risk donors. This not only is an oversight in the article and in its accompanying editorial 1,3 but also is missing from most discussions on this topic. The guidelines clearly recommend that all recipients of organs from increased-risk donors "be tested for HIV immediately before transplantation and at 3 months following transplantation." This case demonstrates some key issues to guide the testing of recipients. First, the patient, like the other transplant recipients, acquired HCV infection without seroconversion; as such, posttransplant testing should use both molecular and serologic methods. Second, although we cannot be sure that earlier testing would have affected the overall course of the patient, it is possible that early identification and treatment of the HIV and HCV infection in the recipient may have improved her outcome. Since the transmission event, at our center, we perform baseline serologic testing for HIV, hepatitis B virus, and HCV immediately preoperatively in all recipients of organs from increased-risk donors, and this is followed by serologic and molecular (quantitative polymerase chain reaction) testing for HIV, hepatitis B virus, and HCV, unless there was pretransplant documentation of protection or infection, at 1 and 3 months post-transplant. Such testing is just as important as the consent of recipients of organs from increased-risk donors. Finally, current Organ Procurement and Transplantation Network policy requires reporting of any donor-derived disease transmission if it is recognized to allow appro...

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Regarding unexpected severe and life-threatening donor-transmitted viral infections and use of high-risk behavior donors

Cited by 7 publications

References 15 publications

Update on donor-derived infections in liver transplantation

Update on donor-derived infections in liver transplantation

Human T-cell leukemia virus type 1 infection worsens prognosis of hepatitis C virus-related living donor liver transplantation

Transmission of human immunodeficiency virus and hepatitis C virus through liver transplantation

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