Published online Jun 24, 2014. doi: 10.5500/wjt.v4.i2.43
Revised: March 21, 2014
Accepted: May 14, 2014
Published online: June 24, 2014
Processing time: 212 Days and 16.1 Hours
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.
Core tip: The literature surrounding preventing donor-transmitted infections in solid organ transplant recipients has increased greatly in the last decade. Increased emphasis has been placed on improved diagnostics for screening of deceased donors. Importance has been placed on using donors who were previously thought to be high risk for transmitting infections to recipients and mitigating the risk to such recipients in an effort to increase the donor pool. Initiating the discussion around using human immunodeficiency virus (HIV) infected donors for HIV infected recipients has important implications for addressing the problem of allograft shortages.