Organ Donation and Transplantation From Donors With Systemic Infection: A Single-Center Experience

Yuan, Xiaopeng; Chen, C.; Zhou, Jian; Han, Ming; Wang, X.; Wang, C.; He, Xiaoshun

doi:10.1016/j.transproceed.2016.02.092

Cited by 12 publications

(14 citation statements)

References 6 publications

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“…Our data are similar to previous reports showing that the highest positive rate of bacterial culture of the donor was from sputum cultures 11 14. The most common pathogens cultivated from bronchial aspirates of the donors in this study were K. pneumoniae and S. aureus .…”

Section: Discussionsupporting

confidence: 92%

“…This study examined all recipient blood cultures for bacteria within 30 days after LT to match the donor’s bacterial infection. In line with previous reports, the incidence of possible bacterial transmission from the donor was very low 10 11. Only one recipient’s blood culture had the same bacterium as the donor, and accounted for only 1.02% of all recipients in the current study.…”

Section: Discussionsupporting

confidence: 89%

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Impact of donor with evidence of bacterial infections on deceased donor liver transplantation: a retrospective observational cohort study in Taiwan

et al. 2019

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ObjectiveThe shortage of available donor organs is an unsolvable concern leading to an expansion in the donor criteria for organ transplantation. Here, we describe our experience and assess the outcomes in recipients who obtained a graft from a donor with bacterial infections in deceased donor liver transplantation (DDLT).MethodsAll DDLTs between January 1991 and February 2017 were retrospectively reviewed. Patients were categorised into two groups based on the recipients who obtained a graft from a donor with (group I) or without (group II) evidence of bacterial infections. Outcomes and bacterial infections were compared between the two groups of recipients.ResultsOverall, a total of 285 DDLTs were performed from 248 donors consisting of 48 split liver grafts and 208 whole liver grafts. Of those, 98 recipients (group I, 34.3%) were transplanted with a graft from 78 donors with positive bacterial cultures. Donor sputum cultures had the highest rate of positive bacterial growth, accounting for 26.6% of donors. Overall survival (OS) was not significantly different between the two groups (p=0.9746). The OS rates at 1 and 3 years were 73.5% and 69.2%, respectively, in the group I recipients versus 68.8% and 62.4% in the group II recipients. Importantly, no hospital mortality was related to donor-derived bacterial infections.ConclusionTransmission of bacteria from the donor to the recipient is infrequent in DDLT. Therefore, potential donors with positive bacterial infections should not be excluded for organ transplantation to increase organ availability and ameliorate the organ shortage.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 89%

Impact of donor with evidence of bacterial infections on deceased donor liver transplantation: a retrospective observational cohort study in Taiwan

et al. 2019

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“…Similarly, immunosuppressed SOT recipients remain at risk because they may develop severe forms of strongyloidiasis infection through transmission from an infected donor allograft [176]. SOT recipients also face high mortality.…”

Section: Liver Transplantationmentioning

confidence: 99%

Stem Cell Therapeutics of Acute Liver Diseases, Transplantation, and Regeneration

Upadhyay¹

2017

J Cell Sci Ther

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Present review article explains various causes of acute liver diseases and their therapeutics. This article describes major reasons of hepatic pathophysiological conditions and diseases including hepatitis, cholestasis, alcoholic and non-alcoholic steatohepatitis, jaundice, liver cirrhosis, carcinogenesis and many others. This article emphasizes use of proliferating hepatocytes, hepatic oval cells, adult human liver mesenchymal stem/progenitor cells, induced pluripotent stem cells (iPSCs) and hematopoietic stem cells in cell transplantation for restoration of liver structure and function. It also justified the therapeutic role of cell secreted growth factors and dietary factors required during natural healing and regeneration liver after surgery or liver transplantation. It sketches out regulatory roles of signaling pathways, expression of cell cycle regulators, growth factors, cytokines, and role of different mitogens in induction of liver stem/progenitor cells (LSPCs) after organ/stem cell transplantation. This article suggests a need for development of new advanced biomaterials, methods, technologies and stem cells for development of targeted therapies to combat and cure liver related diseases and disorders. This article also advice people for avoiding excessive use of alcohol, drugs, fats, salt, high energy diets, and iron as all are responsible of liver cirrhosis, damage and failure.

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“…Little data are available regarding the management of kidney recipients of organs recovered from donors with positive urine cultures without documented concurrent bacteremia/fungemia and their impact on kidney allograft survival. Yuan et al reported two cases of transmission of Candida tropicalis in two renal transplant recipients from a donor with positive urine culture for C tropicalis but no documented fungemia. These two recipients received fluconazole treatment for 1 month, and the renal graft functioned well after a follow‐up of 34 months without recurrence of funguria .…”

Section: Introductionmentioning

confidence: 99%

“…Yuan et al reported two cases of transmission of Candida tropicalis in two renal transplant recipients from a donor with positive urine culture for C tropicalis but no documented fungemia. These two recipients received fluconazole treatment for 1 month, and the renal graft functioned well after a follow‐up of 34 months without recurrence of funguria . Transmission of multidrug‐resistant E coli was also reported in two kidney recipients of an organ donor with positive urine cultures without documented bacteremia prior to organ recovery, leading to graft loss in both cases.…”

Section: Introductionmentioning

confidence: 99%

The role of preemptive antimicrobial therapy in kidney recipients of urine‐only positive donor cultures

Cabrera

Centeno

Revollo

et al. 2019

Transplant Infectious Dis

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Background The use of preemptive antimicrobial therapy for recipients of donors with microbial growth on pre‐transplant urine cultures remains poorly studied. Methods Single‐center retrospective study of kidney transplant recipients of allografts from deceased donors with urine‐only (ie, in absence of donor bacteremia) positive cultures (September 2011 to August 2015). Transplant outcomes, including donor‐derived infections (DDI) within the first three months post transplant, were analyzed. Results Of the 970 kidney transplants performed during the study period, urine cultures were obtained from all donors, and of these, 27 (2.8%) yielded growth. Twenty‐nine (73%) recipients were treated preemptively after transplantation. All of the recipients of donors with urine cultures positive for Enterococcus, Pseudomonas, or Candida spp. received therapy whereas only one of seven recipients with urine cultures positive for Escherichia coli was treated (P < .0001). All E coli isolates were susceptible to trimethoprim‐sulfamethoxazole (TMP‐SMX), which was given to all patients for Pneumocystis pneumonia (PCP) prophylaxis. Infection within 3 months was evident in 16 (40%) patients: 10 out of 29 (35%) in the preemptive group and 6 out of 11 (55%) in the not‐treatment group (P = .29). Evidence of DDI occurred in two recipients, one in each group. There were no differences in one‐year graft and patient survival between groups. Conclusion Preemptive antibiotic therapy did not seem to impact transmission events and transplant outcomes in this small cohort. Low transmission rates might have been influenced by administration of PCP prophylaxis and universal preemptive therapy for positive donor urine cultures with virulent organisms. Larger studies are needed.

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Organ Donation and Transplantation From Donors With Systemic Infection: A Single-Center Experience

Cited by 12 publications

References 6 publications

Impact of donor with evidence of bacterial infections on deceased donor liver transplantation: a retrospective observational cohort study in Taiwan

Impact of donor with evidence of bacterial infections on deceased donor liver transplantation: a retrospective observational cohort study in Taiwan

Stem Cell Therapeutics of Acute Liver Diseases, Transplantation, and Regeneration

The role of preemptive antimicrobial therapy in kidney recipients of urine‐only positive donor cultures

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