The summaries are free for public
use. The Chronic Liver Disease
Foundation will continue to add and
archive summaries of articles deemed
relevant to CLDF by the Board of
Trustees and its Advisors.
Abstract Details
Characteristics and Donation Outcomes of Potential Organ Donors Perceived to be at Increased Risk for Blood Borne Virus Transmission: an Australian Cohort Study 2010-2018
Transplantation. 2021 Feb 22. doi: 10.1097/TP.0000000000003715. Online ahead of print.
Karen M J Waller1, Nicole L De La Mata, Brenda M Rosales, James A Hedley, Patrick J Kelly, Imogen K Thomson, Michael J O'Leary, Elena Cavazzoni, Vidiya Ramachandran, William D Rawlinson, Kate R Wyburn, Angela C Webster
Author information
11 Centre for Organ Donation Evidence, Sydney School of Public Health, Faculty of Health and Medicine, The University of Sydney, Camperdown, NSW, 2 NSW Organ and Tissue Donation Service, Kogarah, NSW 3 Intensive Care Service, Royal Prince Alfred Hospital, Camperdown, NSW 4 Serology and Virology Division, NSW Health Pathology, Randwick, Prince of Wales Hospital 5 Schools of SOMS, BABS and Women's and Children's, University of NSW 6 Department of Renal Medicine, Royal Prince Alfred Hospital, Camperdown, NSW 7 Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia 8 Centre for Transplant and Renal Research, Westmead Hospital, Westmead, NSW.
Abstract
Introduction: Safely increasing organ donation to meet need is a priority. Potential donors may be declined due to perceived blood borne virus (BBV) transmission risk. With hepatitis C (HCV) curative therapy, more potential donors may now be suitable. We sought to describe potential deceased donors with increased BBV transmission risk.
Methods: We conducted a cohort study of all potential organ donors referred in New South Wales, Australia, 2010-2018. We compared baseline risk potential donors to potential donors with increased BBV transmission risk, due to history of HIV, HCV or hepatitis B and/or behavioural risk factors.
Results: There were 624/5749 potential donors (10.9%) perceived to have increased BBV transmission risk. This included 298/5749 (5.2%) with HCV (including HBV co-infections) and 239/5749 (4.2%) with increased risk behaviours (no known BBV). Potential donors with HCV and those with increased risk behaviours were younger and had fewer comorbidities than baseline risk potential donors (p<0.001). Many potential donors (82 with HCV, 38 with risk behaviours) were declined for donation purely due to perceived BBV transmission risk. Most were excluded prior to BBV testing. When potential donors with HCV did donate, they donated fewer organs than baseline risk donors (median 1 versus 3, p<0.01), especially kidneys (OR 0.08, p<0.001) and lungs (OR 0.11, p=0.006).
Conclusion: Many potential donors were not accepted due to perceived increased BBV transmission risk, without viral testing, and despite otherwise favourable characteristics. Transplantation could be increased from potential donors with HCV and/or increased risk behaviours.Supplemental Visual Abstract; http://links.lww.com/TP/C158.