Impact of repeat testing of living kidney donors within 14 days of the transplant procedure: A multicenter retrospective survey

I. A. Echenique, D. Cohen, D. L. Rudow, M. G. Ison*

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: A transmission of human immunodeficiency virus (HIV) from a live kidney donor prompted recommendations by the New York State Department of Health and the US Centers for Disease Control and Prevention that all live donors undergo additional screening for HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) within 7-14 days of the donation procedure. There are concerns that re-screening will result in delays and cancelled transplants. Methods: We surveyed live-donor transplant centers in New York State to assess their screening protocols and outcomes. Nine live-donor programs (kidney and liver centers) responded. Results: All but 1 program has a formal repeat screening policy. Overall, no cancellations occurred, but 2 centers experienced transplantation delays, generally as the result of technician and laboratory procedural mistakes necessitating repeat phlebotomy. Testing is typically coordinated with pre-surgical visits, additional laboratory tests, and physical examinations. In the initial evaluation, serology was most frequently used (all 9 centers), with few centers utilizing nucleic acid testing (NAT) (HIV NAT, 1; HBV NAT, 2; HCV NAT, 2). Repeat testing modalities varied: HIV antibody (5, 55%), HIV NAT (8, 88%), hepatitis B surface antigen (5, 55%), hepatitis B surface antibody (2, 22%), hepatitis B core antibody (3, 33%), HBV NAT (3, 33%), HCV antibody (3, 33%), and HCV NAT (5, 55%). Conclusion: Most respondents have policies to re-test living donors within 14 days of the transplant procedures. Rarely, centers encountered repeat testing-associated delays, but no cancellations occurred.

Original languageEnglish (US)
Pages (from-to)403-411
Number of pages9
JournalTransplant Infectious Disease
Volume16
Issue number3
DOIs
StatePublished - Jan 1 2014

Fingerprint

Living Donors
Nucleic Acids
Transplants
Kidney
HIV
Hepatitis B virus
Tissue Donors
Hepacivirus
Hepatitis B Antibodies
Laboratory Personnel
Hepatitis C Antibodies
Phlebotomy
Serology
Centers for Disease Control and Prevention (U.S.)
Hepatitis B Surface Antigens
Surveys and Questionnaires
Physical Examination
Transplantation
Antibodies
Liver

Keywords

  • Donor-derived infection
  • Hepatitis B virus
  • Hepatitis C virus
  • Human immunodeficiency virus
  • Living kidney donation
  • Living liver donation
  • Nucleic acid testing
  • Serology

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases

Cite this

@article{91cce839e6d647b298f6e56c9f48acba,
title = "Impact of repeat testing of living kidney donors within 14 days of the transplant procedure: A multicenter retrospective survey",
abstract = "Background: A transmission of human immunodeficiency virus (HIV) from a live kidney donor prompted recommendations by the New York State Department of Health and the US Centers for Disease Control and Prevention that all live donors undergo additional screening for HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) within 7-14 days of the donation procedure. There are concerns that re-screening will result in delays and cancelled transplants. Methods: We surveyed live-donor transplant centers in New York State to assess their screening protocols and outcomes. Nine live-donor programs (kidney and liver centers) responded. Results: All but 1 program has a formal repeat screening policy. Overall, no cancellations occurred, but 2 centers experienced transplantation delays, generally as the result of technician and laboratory procedural mistakes necessitating repeat phlebotomy. Testing is typically coordinated with pre-surgical visits, additional laboratory tests, and physical examinations. In the initial evaluation, serology was most frequently used (all 9 centers), with few centers utilizing nucleic acid testing (NAT) (HIV NAT, 1; HBV NAT, 2; HCV NAT, 2). Repeat testing modalities varied: HIV antibody (5, 55{\%}), HIV NAT (8, 88{\%}), hepatitis B surface antigen (5, 55{\%}), hepatitis B surface antibody (2, 22{\%}), hepatitis B core antibody (3, 33{\%}), HBV NAT (3, 33{\%}), HCV antibody (3, 33{\%}), and HCV NAT (5, 55{\%}). Conclusion: Most respondents have policies to re-test living donors within 14 days of the transplant procedures. Rarely, centers encountered repeat testing-associated delays, but no cancellations occurred.",
keywords = "Donor-derived infection, Hepatitis B virus, Hepatitis C virus, Human immunodeficiency virus, Living kidney donation, Living liver donation, Nucleic acid testing, Serology",
author = "Echenique, {I. A.} and D. Cohen and Rudow, {D. L.} and Ison, {M. G.}",
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Impact of repeat testing of living kidney donors within 14 days of the transplant procedure : A multicenter retrospective survey. / Echenique, I. A.; Cohen, D.; Rudow, D. L.; Ison, M. G.

In: Transplant Infectious Disease, Vol. 16, No. 3, 01.01.2014, p. 403-411.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of repeat testing of living kidney donors within 14 days of the transplant procedure

T2 - A multicenter retrospective survey

AU - Echenique, I. A.

AU - Cohen, D.

AU - Rudow, D. L.

AU - Ison, M. G.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: A transmission of human immunodeficiency virus (HIV) from a live kidney donor prompted recommendations by the New York State Department of Health and the US Centers for Disease Control and Prevention that all live donors undergo additional screening for HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) within 7-14 days of the donation procedure. There are concerns that re-screening will result in delays and cancelled transplants. Methods: We surveyed live-donor transplant centers in New York State to assess their screening protocols and outcomes. Nine live-donor programs (kidney and liver centers) responded. Results: All but 1 program has a formal repeat screening policy. Overall, no cancellations occurred, but 2 centers experienced transplantation delays, generally as the result of technician and laboratory procedural mistakes necessitating repeat phlebotomy. Testing is typically coordinated with pre-surgical visits, additional laboratory tests, and physical examinations. In the initial evaluation, serology was most frequently used (all 9 centers), with few centers utilizing nucleic acid testing (NAT) (HIV NAT, 1; HBV NAT, 2; HCV NAT, 2). Repeat testing modalities varied: HIV antibody (5, 55%), HIV NAT (8, 88%), hepatitis B surface antigen (5, 55%), hepatitis B surface antibody (2, 22%), hepatitis B core antibody (3, 33%), HBV NAT (3, 33%), HCV antibody (3, 33%), and HCV NAT (5, 55%). Conclusion: Most respondents have policies to re-test living donors within 14 days of the transplant procedures. Rarely, centers encountered repeat testing-associated delays, but no cancellations occurred.

AB - Background: A transmission of human immunodeficiency virus (HIV) from a live kidney donor prompted recommendations by the New York State Department of Health and the US Centers for Disease Control and Prevention that all live donors undergo additional screening for HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) within 7-14 days of the donation procedure. There are concerns that re-screening will result in delays and cancelled transplants. Methods: We surveyed live-donor transplant centers in New York State to assess their screening protocols and outcomes. Nine live-donor programs (kidney and liver centers) responded. Results: All but 1 program has a formal repeat screening policy. Overall, no cancellations occurred, but 2 centers experienced transplantation delays, generally as the result of technician and laboratory procedural mistakes necessitating repeat phlebotomy. Testing is typically coordinated with pre-surgical visits, additional laboratory tests, and physical examinations. In the initial evaluation, serology was most frequently used (all 9 centers), with few centers utilizing nucleic acid testing (NAT) (HIV NAT, 1; HBV NAT, 2; HCV NAT, 2). Repeat testing modalities varied: HIV antibody (5, 55%), HIV NAT (8, 88%), hepatitis B surface antigen (5, 55%), hepatitis B surface antibody (2, 22%), hepatitis B core antibody (3, 33%), HBV NAT (3, 33%), HCV antibody (3, 33%), and HCV NAT (5, 55%). Conclusion: Most respondents have policies to re-test living donors within 14 days of the transplant procedures. Rarely, centers encountered repeat testing-associated delays, but no cancellations occurred.

KW - Donor-derived infection

KW - Hepatitis B virus

KW - Hepatitis C virus

KW - Human immunodeficiency virus

KW - Living kidney donation

KW - Living liver donation

KW - Nucleic acid testing

KW - Serology

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