Perspectives on donor-derived infections from Germany.

Autor: Barreiros AP; Geschäftsführende Ärztin, Deutsche Stiftung Organtransplantation, Region Mitte, Organisationszentrale, Mainz, Germany., Böhler K; Deutsche Stiftung Organtransplantation, Hauptverwaltung, Frankfurt, Germany., Mönch K; Verbundprojekt KITTU, Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsmedizin Mainz, Mainz, Germany., Fischer-Fröhlich CL; Deutsche Stiftung Organtransplantation, Region Baden-Württemberg, Organisationszentrale, Stuttgart, Germany., Rahmel A; Deutsche Stiftung Organtransplantation, Hauptverwaltung, Frankfurt, Germany.
Jazyk: angličtina
Zdroj: Transplant infectious disease : an official journal of the Transplantation Society [Transpl Infect Dis] 2024 Nov; Vol. 26 Suppl 1, pp. e14372. Date of Electronic Publication: 2024 Sep 23.
DOI: 10.1111/tid.14372
Abstrakt: Aim: Often, organ transplantation is the only option to improve the life expectancy and quality of life of patients with terminal organ failure. Despite improved donor and organ assessment, a residual risk remains for transmitting infection, tumor, or other disease from the donor to recipients. Analysis, reporting, and managing of donor-derived diseases through a vigilance and surveillance system (V&S) is mandatory in many countries. We report on suspected and proven/probable donor-derived infections (DDI) in Germany over a period of 8 years (2016-2023).
Methods: All incoming serious-adverse-event and serious-adverse-reaction (SAE/SAR) reports from 01.01.2016 to 31.12.2023 were evaluated for suspected DDI. Analysis of imputability followed the definition of the US Disease Transmission Advisory Committee (DTAC). Only probable and proven cases according to DTAC classification were defined as DDI.
Results: During the study period, 9771 donors in Germany donated post-mortem organs to 27 919 recipients. In that period 612 SAE/SAR cases were reported, 377 (62%) involved infections. 41 cases were proven/probable DDI affecting 58 recipients (seven recipients died, 12%). Suspected infections were bacterial (182/377, 48%), fungal (135/377, 36%), viral (55/377, 15%), and parasitic (5/377, 1%). In case of bacterial DDI, no recipient died, but organ loss occurred in six recipients. In case of fungal or viral DDI, 19% (3/16) and 21% (3/14) of the recipients died, respectively.
Conclusions: DDI are rare in solid organ transplantation (58/27 919, 0.21%), but when they occur, they are associated with high morbidity and mortality in affected recipients. Careful and detailed donor evaluation and a reliable V&S help improve recipient safety.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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