Jr CSK, Koval CE, Duin DV, Morais AG, Gonzalez BE, Avery RK, Mawhorter SD, Brizendine KD, Cober ED, Miranda C, Shrestha RK, Teixeira L, Mossad SB. Selecting suitable solid organ transplant donors: Reducing the risk of donor-transmitted infections. World J Transplant 2014; 4(2): 43-56 [PMID: 25032095 DOI: 10.5500/wjt.v4.i2.43]
Corresponding Author of This Article
Sherif B Mossad, MD, Department of Infectious Diseases, Medicine Institute, Cleveland Clinic, 9500 Euclid Ave, Mailstop G-21, room 131, Cleveland, OH 44195, United States. mossads@ccf.org
Research Domain of This Article
Infectious Diseases
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Jun 24, 2014; 4(2): 43-56 Published online Jun 24, 2014. doi: 10.5500/wjt.v4.i2.43
Selecting suitable solid organ transplant donors: Reducing the risk of donor-transmitted infections
Christopher S Kovacs Jr, Christine E Koval, David van Duin, Amanda Guedes de Morais, Blanca E Gonzalez, Robin K Avery, Steven D Mawhorter, Kyle D Brizendine, Eric D Cober, Cyndee Miranda, Rabin K Shrestha, Lucileia Teixeira, Sherif B Mossad
Christopher S Kovacs Jr, Christine E Koval, Steven D Mawhorter, Kyle D Brizendine, Eric D Cober, Cyndee Miranda, Rabin K Shrestha, Lucileia Teixeira, Sherif B Mossad, Department of Infectious Diseases, Medicine Institute, Cleveland Clinic, Cleveland, OH 44195, United States
David van Duin, Division of Infectious Diseases, Immunocompromised Host Infectious Disease Program, University of North Carolina, Chapel Hill, NC 27599, United States
Amanda Guedes de Morais, Infectious Disease and Internal Medicine, Augusta Health, Fishersville, VA 22939, United States
Blanca E Gonzalez, Department of Pediatric Infectious Diseases, Cleveland Clinic Children’s, Cleveland, OH 44195, United States
Robin K Avery, Division of Infectious Disease (Transplant/Oncology), Johns Hopkins, Baltimore, MD 21205, United States
Author contributions: Avery RK created the idea of an institutional approach for donor suitability; Koval CE, van Duin D, Mawhorter SD, Brizendine KD, Guedes de Morais A, Gonzalez BE, Cober ED, Miranda C, Shrestha RK, Teixeira L and Mossad S wrote material from which sections were synthesized and reviewed and approved the final draft; Kovacs Jr CS and Mossad SB coordinated and synthesized data, wrote, and compiled the final submitted draft.
Correspondence to: Sherif B Mossad, MD, Department of Infectious Diseases, Medicine Institute, Cleveland Clinic, 9500 Euclid Ave, Mailstop G-21, room 131, Cleveland, OH 44195, United States. mossads@ccf.org
Telephone: +1-216-4452572 Fax: +1-216-4459446
Received: December 20, 2013 Revised: March 21, 2014 Accepted: May 14, 2014 Published online: June 24, 2014 Processing time: 212 Days and 16.1 Hours
Abstract
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.
