Recently Acquired Blood-borne Virus Infections in Australian Deceased Organ Donors: Estimation of the Residual Risk of Unexpected Transmission.

Autor:	Dutch MJ; Emergency Department, Royal Melbourne Hospital, Melbourne, Australia.; Department of Critical Care, University of Melbourne, Melbourne, Australia., Seed CR; Clinical Services and Research, Australian Red Cross Blood Service, Perth, Australia.; Medical School, University of Western Australia, Perth, Australia., Cheng A; Clinical Services and Research, Australian Red Cross Blood Service, Perth, Australia., Kiely P; Department of Clinical Services and Research, Australian Red Cross Blood Service, Melbourne, Australia., Patrick CJ; Statistical Consultancy Centre, University of Melbourne, Melbourne, Australia., Opdam HI; Intensive Care Unit, Austin Hospital, Melbourne, Australia.; The Australian Organ and Tissue Authority, Canberra, Australia., Knott JC; Emergency Department, Royal Melbourne Hospital, Melbourne, Australia.; Department of Critical Care, University of Melbourne, Melbourne, Australia.
Jazyk:	angličtina
Zdroj:	Transplantation direct [Transplant Direct] 2023 Feb 17; Vol. 9 (3), pp. e1447. Date of Electronic Publication: 2023 Feb 17 (Print Publication: 2023).
DOI:	10.1097/TXD.0000000000001447
Abstrakt:	Unexpected donor-derived infections of hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV are rare but important potential complications of deceased organ transplantation. The prevalence of recently acquired (yield) infections has not been previously described in a national cohort of Australian deceased organ donors. Donor yield infections are of particularly significance, as they can be used to gain insights in the incidence of disease in the donor pool and in turn, estimate the risk of unexpected disease transmission to recipients. Methods: We conducted a retrospective review of all patients who commenced workup for donation in Australia between 2014 and 2020. Yield cases were defined by having both unreactive serological screening for current or previous infection and reactive nucleic acid testing screening on initial and repeat testing. Incidence was calculated using a yield window estimate and residual risk using the incidence/window period model. Results: The review identified only a single yield infection of HBV in 3724 persons who commenced donation workup. There were no yield cases of HIV or HCV. There were no yield infections in donors with increased viral risk behaviors. The prevalence of HBV, HCV, and HIV was 0.06% (0.01-0.22), 0.00% (0-0.11), and 0.00% (0-0.11), respectively. The residual risk of HBV was estimated to be 0.021% (0.001-0.119). Conclusions: The prevalence of recently acquired HBV, HCV, and HIV in Australians who commence workup for deceased donation is low. This novel application of yield-case-methodology has produced estimates of unexpected disease transmission which are modest, particularly when contrasted with local average waitlist mortality. Supplemental Visual Abstract; http://links.lww.com/TXD/A503. Competing Interests: The authors declare no funding or conflicts of interest. (Copyright © 2023 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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