COMPLICATIONS - INFECTIONS

D.J. Conti¹, R. Kochik^2
1Surgery, Albany Medical Center, Albany,New York/UNITED STATES OF AMERICA, ², Finger Lakes Donor Recovery Network, Albany, new york/UNITED STATES OF AMERICA

Body: Introduction In March 2006, the United Network for Organ Sharing (UNOS) initiated a requirement for reporting of organ donor disease transmission after transplantation. Within the first year of this requirement, 10 cases of donor disease transmission were identified in New York State (NYS), UNOS region 9. These included transmission of chagas disease, west nile virus, schistosomiasis, tuberculosis and lymphoma. In response, a workgroup was established in 2007 under the auspices of the NYS Department of Health (DOH) Transplant Council to evaluate this issue and develop state-wide and UNOS region 9 recommendations in an attempt to decrease infectious disease transmission and facilitate early diagnosis and treatment when transmission occurs through life-saving organ donation. Methods Workgroup membership was comprised of NYS transplant and organ procurement organization (OPO) professionals, as well as representatives of the centers for disease control and prevention (CDC), UNOS Disease Transmission Advisory Committee (DTAC) and the Division of Epidemiology, NYS Department of Health. The workgroup deliberations resulted in the following recommendations approved by the NYS-DOH in 2009. Results 1) The establishment of a formal process of communications for suspected and confirmed donor disease transmissions among the OPO's, transplant centers and NYS-DOH as follows. When a suspected transmission is recognized, the transplant center will immediately contact the OPO. The OPO then has the responsibility to communicate the suspected transmission to any other potentially affected transplant center, tissue bank, DTAC and the NYS-DOH. Each transplant center and OPO is to designate staff, with coverage, so that there is a person available 24/7, to be the primary contact for disease transmission events. The transplant centers and OPOs should facilitate direct clinician-to-clinician communication regarding suspected cases of disease transmission. 2) All organ donors that meet current CDC high-risk guidelines should have nucleic acid testing (NAT) in addition to serologic testing for HIV and hepatitis C Conclusion To our knowledge this is the first collaborative effort of the OPOs and transplant centers within an entire UNOS region to minimize donor disease transmission and facilitate early detection and treatment when donor-related disease transmission occurs after transplantation.

Disclosure: All authors have declared no conflicts of interest.