Deceased organ donor screening for human immunodeficiency virus, hepatitis B virus and hepatitis C virus: Discordant serology and nucleic acid testing results

Transplant Infectious Disease - Tập 20 Số 1 - 2018
Nicole Theodoropoulos1, Marek Nowicki2, C. Chinchilla-Reyes2, Sara Dionne3, Andrés Jaramillo4,5, Tom Mone6, Richard Hasz7, Martin D. Jendrisak5, Daniela P. Ladner8,9, Michael G. Ison10,8,9
1Division of Infectious Diseases & Immunology, Department of Medicine, University of Massachusetts, Worcester, MA, USA
2Mendez National Institute of Transplantation, Los Angeles, CA, USA
3Labs, Inc., Philadelphia, PA, USA
4Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, AZ, USA
5Gift of Hope Organ & Tissue Donor Network Itasca IL USA
6OneLegacy, Los Angeles, CA, USA
7Gift of Life Donor Program, Philadelphia, PA, USA
8Division of Organ Transplantation, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
9Northwestern University Transplant Outcomes Research Collaborative, Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
10Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

Tóm tắt

AbstractBackground

Before the 2014 policy change pertaining to infectious disease screening, many organ procurement organizations (OPOs) were supplementing serologic screening of deceased organ donors with nucleic acid testing (NAT) for human immunodeficiency virus (HIV‐1), hepatitis B virus (HBV), and hepatitis C virus (HCV). The number of seronegative, NAT‐positive donors has not been directly measured.

Methods

HIV, HBV, and HCV screening results of 11 229 donor referrals evaluated from 2010 to 2013 were obtained from 3 OPO‐affiliated laboratories, capturing 35% of all donors in the United States. Laboratories used either polymerase chain reaction assay or transcription‐mediated amplification assay to test 9643 deceased donors by NAT.

Results

The NAT results were positive in 21 (0.2%), 1 (0.02%), and 11 (0.1%) donors who were seronegative for HIV, HBV, and HCV, respectively. All discordant HIV‐1 results were from one laboratory using a polymrease chain reaction assay. Thirteen of the reactive HIV NAT results in seronegative referrals were repeated and were non‐reproducibly positive (NRP). Ten (0.1%), 452 (7.8%), and 197 (2.2%) of HIV‐, HBV‐, and HCV‐seropositive donors, respectively, were negative by NAT.

Conclusions

This study highlights the importance of robust quality assurance to minimize NRP NAT results. NAT may allow for increased utilization of organs from HBV‐ and HCV‐seropositive, NAT‐negative donors.

Từ khóa


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Transplant Infectious Disease

Tập 20 Số 1

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