Incidence and Clinical Relevance of Bacterial Contamination in Preservation Solution for Liver Transplantation

Ruíz, P.; Gastaca, Mikel; Gonzalez, J.; Hernandez, Matthew; Ventoso, A.; Valdivieso, A.; Montejo, Miguel; Urbina, J. Ortiz de

doi:10.1016/j.transproceed.2009.06.036

Cited by 26 publications

(35 citation statements)

References 7 publications

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“…Therefore, we estimate that over 50% of pancreata distributed for whole-organ transplant are likely to be transported in microbially contaminated transport fluid. This conclusion is supported by internal data and data from other centers, which show that contaminants are commonly found in transport fluid following heart, kidney, or liver procurement (9,10,11). Because islet cells are normally transplanted 24 to 48 h after isolation, rapid methods of microbial detection would benefit islet transplant programs by identifying potentially hazardous contaminants in transport fluid and postpurification samples that would preclude transplantation of the product or by allowing earlier intervention in the event that a contaminated product was transplanted.…”

supporting

confidence: 54%

Use of the BacT/Alert System for Rapid Detection of Microbial Contamination in a Pilot Study Using Pancreatic Islet Cell Products

et al. 2014

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At the Islet Isolation Laboratory of the Scottish National Blood Transfusion Service, manual sterility testing data show that contamination rates are 57.7% for pancreas transport fluid, 4.3% for postpurification islet samples, and 0% for pretransplant islet samples. This pilot study presents the BacT/Alert System as an alternative to manual testing to provide more rapid and sensitive sterility results for islet cell products.

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supporting

confidence: 54%

Use of the BacT/Alert System for Rapid Detection of Microbial Contamination in a Pilot Study Using Pancreatic Islet Cell Products

et al. 2014

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“…The high proportion of coagulase‐negative staphylococci in the study of Cerutti et al (4), compared with our study, strongly suggests contamination during harvesting. In a recent study, Ruiz et al (5) found 98.4% contaminated PF, including a vast majority of coagulase‐negative staphylococci also indicating frequent contamination during the procedure. The predominance of Enterobacteriaceae in our liver PFs and the frequent presence of the same species in the PF of other organs may suggest donor infection at the time of organ procurement.…”

Section: Discussionmentioning

confidence: 98%

“…A transmission rate of 0% has been recently described (5). However, only infections occurring during the first 24 postoperative hours were taken into account, questioning the relevance of this rate.…”

Section: Discussionmentioning

confidence: 99%

Microbiological findings of culture‐positive preservation fluid in liver transplantation

Janny

Bert

Dondero

et al. 2010

Transplant Infectious Dis

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Bacterial and fungal infections are the leading cause of mortality in liver transplant (LT) recipients. Few studies have examined the incidence of culture-positive preservation fluid (PF) and the outcome of related recipients. The aim of this study was to determine the incidence and the microbiologic findings of PF positive cultures, and to evaluate the impact on morbidity and mortality of LT recipients. A retrospective analysis of PF cultures performed after 477 LTs from cadaveric grafts between January 2001 and February 2008 was conducted. Forty-five (9.5%) PFs were found to be positive with 1 or 2 pathogens. The demographic profiles of recipients of PF with positive or negative cultures were similar. Enterobacteriaceae species were the most frequent organisms (n = 30), followed by Staphylococcus aureus (n = 5), coagulase-negative staphylococci (n = 5), enterococci (n = 4), and yeasts (n = 3). Mortality rate at 1 month was not significantly different in recipients with positive or sterile PF cultures (88.1% vs. 87.7%, respectively). The rate of bacteremia among LT recipients with positive or negative PF cultures was not statistically different. Systemic infections caused by the pathogen cultured from the PF occurred in 8 (18%) of the 45 recipients, including bacteremia (4/8) or intra-abdominal sepsis (5/8). Causative organisms were Enterobacteriaceae species (n = 5), Candida species (n = 2), and Enterococcus faecium (n = 1). Among the 8 patients who developed infection with the PF organism, 4 (50%) died in the intensive care unit (ICU) vs. an ICU mortality rate of 8% (3/37) in those who did not develop infection with the PF organism (P < 0.05). Infection occurred less frequently in recipients who received antimicrobial therapy with activity against the PF isolate than in those without appropriate treatment (41% vs. 3.8%, P < 0.005). Those who develop infection with organisms recovered from PF cultures appear to have high early mortality rates; therefore, appropriate antimicrobial therapy against organisms cultured from PF should be given.

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“…Cultures of organ procurement fluid (OPF) have been studied as a potential source of DTI. OPF cultures are commonly positive for the growth of bacteria, with low-virulence bacteria such as coagulase-negative staphylococcus and Corynebacterium [55][56][57][58][59][60] . Studies are variable on whether positive OPF cultures portend an increased risk for posttransplant infection.…”

Section: Bacterial Infectionsmentioning

confidence: 99%

Selecting suitable solid organ transplant donors: Reducing the risk of donor-transmitted infections

Kovacs¹,

Koval²,

Duin³

et al. 2014

WJT

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Selection of the appropriate donor is essential to a successful allograft recipient outcome for solid organ transplantation. Multiple infectious diseases have been transmitted from the donor to the recipient via transplantation. Donor-transmitted infections cause increased morbidity and mortality to the recipient. In recent years, a series of high-profile transmissions of infections have occurred in organ recipients prompting increased attention on the process of improving the selection of an appropriate donor that balances the shortage of needed allografts with an approach that mitigates the risk of donor-transmitted infection to the recipient. Important advances focused on improving donor screening diagnostics, using previously excluded high-risk donors, and individualizing the selection of allografts to recipients based on their prior infection history are serving to increase the donor pool and improve outcomes after transplant. This article serves to review the relevant literature surrounding this topic and to provide a suggested approach to the selection of an appropriate solid organ transplant donor.

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Incidence and Clinical Relevance of Bacterial Contamination in Preservation Solution for Liver Transplantation

Cited by 26 publications

References 7 publications

Use of the BacT/Alert System for Rapid Detection of Microbial Contamination in a Pilot Study Using Pancreatic Islet Cell Products

Use of the BacT/Alert System for Rapid Detection of Microbial Contamination in a Pilot Study Using Pancreatic Islet Cell Products

Microbiological findings of culture‐positive preservation fluid in liver transplantation

Selecting suitable solid organ transplant donors: Reducing the risk of donor-transmitted infections

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