TY - JOUR
T1 - Screening of living organ donors for endemic infections
T2 - Understanding the challenges and benefits of enhanced screening
AU - Rosen, Amanda
AU - Ison, Michael G.
N1 - Publisher Copyright:
© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Living organ donor candidates are screened for medical and psychosocial contraindications to donation. One important goal of this process is to prevent donor-derived infectious diseases transmissions. These transmissions are exceptionally rare, but have the potential to cause significant morbidity and mortality. The Organ Procurement and Transplantation Network now requires each recovery hospital to develop a protocol for evaluating living donors for tuberculosis and other geographically defined endemic pathogens, including Trypanosoma cruzi (the causative pathogen of Chagas’ disease), Strongyloides stercoralis, and West Nile Virus (WNV), in addition to universal screening for blood-borne pathogens. Enhanced screening requirements were developed in response to the changing epidemiology and endemicity of these diseases, as well as recent case reports of donor-derived disease transmission. Living organ donor disease screening presents a number of unique challenges to clinicians and policy-makers, including deciding which donors to test, which testing modality to use, when to test, and appropriate interpretation of results. This review will analyze the epidemiology of T. cruzi, S. stercoralis, and WNV, the assays available for screening for these diseases, and the subsequent impact on the living organ donor process.
AB - Living organ donor candidates are screened for medical and psychosocial contraindications to donation. One important goal of this process is to prevent donor-derived infectious diseases transmissions. These transmissions are exceptionally rare, but have the potential to cause significant morbidity and mortality. The Organ Procurement and Transplantation Network now requires each recovery hospital to develop a protocol for evaluating living donors for tuberculosis and other geographically defined endemic pathogens, including Trypanosoma cruzi (the causative pathogen of Chagas’ disease), Strongyloides stercoralis, and West Nile Virus (WNV), in addition to universal screening for blood-borne pathogens. Enhanced screening requirements were developed in response to the changing epidemiology and endemicity of these diseases, as well as recent case reports of donor-derived disease transmission. Living organ donor disease screening presents a number of unique challenges to clinicians and policy-makers, including deciding which donors to test, which testing modality to use, when to test, and appropriate interpretation of results. This review will analyze the epidemiology of T. cruzi, S. stercoralis, and WNV, the assays available for screening for these diseases, and the subsequent impact on the living organ donor process.
KW - donor screening
KW - infectious diseases
KW - living donation
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U2 - 10.1111/tid.12633
DO - 10.1111/tid.12633
M3 - Review article
C2 - 27862705
AN - SCOPUS:85007613420
SN - 1398-2273
VL - 19
JO - Transplant Infectious Disease
JF - Transplant Infectious Disease
IS - 1
M1 - e12633
ER -