New blood-borne virus infections among organ transplant recipients: An Australian data-linked cohort study examining donor transmissions and other HIV, hepatitis C and hepatitis B notifications, 2000-2015.

Autor: Waller KMJ; Faculty of Health and Medicine, Sydney School of Public Health, Centre for Organ Donation Evidence, University of Sydney, Sydney, NSW, Australia., De La Mata NL; Faculty of Health and Medicine, Sydney School of Public Health, Centre for Organ Donation Evidence, University of Sydney, Sydney, NSW, Australia., Hedley JA; Faculty of Health and Medicine, Sydney School of Public Health, Centre for Organ Donation Evidence, University of Sydney, Sydney, NSW, Australia., Rosales BM; Faculty of Health and Medicine, Sydney School of Public Health, Centre for Organ Donation Evidence, University of Sydney, Sydney, NSW, Australia.; Department of Renal Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia., O'Leary MJ; New South Wales Organ and Tissue Donation Service, Sydney, NSW, Australia.; Department of Intensive Care Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia., Cavazzoni E; New South Wales Organ and Tissue Donation Service, Sydney, NSW, Australia., Ramachandran V; Serology and Virology Division, NSW Health Pathology Randwick Prince of Wales Hospital, Randwick, NSW, Australia., Rawlinson WD; Serology and Virology Division, NSW Health Pathology Randwick Prince of Wales Hospital, Randwick, NSW, Australia.; Schools of SOMS, BABS and Women's and Children's, University of NSW, Kensington, NSW, Australia., Kelly PJ; Faculty of Health and Medicine, Sydney School of Public Health, Centre for Organ Donation Evidence, University of Sydney, Sydney, NSW, Australia., Wyburn KR; Department of Renal Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.; Faculty of Health and Medicine, Sydney Medical School, University of Sydney, Sydney, NSW, Australia., Webster AC; Faculty of Health and Medicine, Sydney School of Public Health, Centre for Organ Donation Evidence, University of Sydney, Sydney, NSW, Australia.; Centre for Transplant and Renal Research, Westmead Hospital, Sydney, NSW, Australia.
Jazyk: angličtina
Zdroj: Transplant infectious disease : an official journal of the Transplantation Society [Transpl Infect Dis] 2020 Dec; Vol. 22 (6), pp. e13437. Date of Electronic Publication: 2020 Aug 27.
DOI: 10.1111/tid.13437
Abstrakt: Background: Blood-borne viral infections can complicate organ transplantation. Systematic monitoring to distinguish donor-transmitted infections from other new infections post transplant is challenging. Administrative health data can be informative. We aimed to quantify post-transplant viral infections, specifically those transmitted by donors and those reactivating or arising new in recipients.
Methods: We linked transplant registries with administrative health data for all solid organ donor-recipient pairs in New South Wales, Australia, 2000-2015. All new recipient notifications of hepatitis B (HBV), C (HCV), or human immunodeficiency virus (HIV) after transplant were identified. Proven/probable donor transmissions within 12 months of transplant were classified using an international algorithm.
Results: Of 2120 organ donors, there were 72 with a viral infection (9/72 active, 63/72 past). These 72 donors donated to 173 recipients, of whom 24/173 already had the same infection as their donor, and 149/173 did not, so were at risk of donor transmission. Among those at risk, 3/149 recipients had proven/probable viral transmissions (1 HCV, 2 HBV); none were unrecognized by donation services. There were no deaths from transmissions. There were no donor transmissions from donors without known blood-borne viruses. An additional 68 recipients had new virus notifications, of whom 2/68 died, due to HBV infection.
Conclusion: This work confirms the safety of organ donation in an Australian cohort, with no unrecognized viral transmissions and most donors with viral infections not transmitting the virus. This may support targeted increases in donation from donors with viral infections. However, other new virus notifications post transplant were substantial and are preventable. Data linkage can enhance current biovigilance systems.
(© 2020 Wiley Periodicals LLC.)
Databáze: MEDLINE
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