Ruiz I, Gavaldà J, Monforte V, Len O, Román A, Bravo C, Ferrer A, Tenorio L, Román F, Maestre J, Molina I, Morell F, Pahissa A
Department of Infectious Diseases, Hospital General Vall d'Hebron, Universitat Autonoma de Barcelona, Spain.
Am J Transplant. 2006 Jan;6(1):178-82. doi: 10.1111/j.1600-6143.2005.01145.x.
The purpose of this study was to evaluate the incidence and etiology of bacterial and fungal infection or contamination in lung allograft donors and to assess donor-to-host transmission of these infections. Recipients who survived more than 24 h and their respective donors were evaluated. The overall incidence of donor infection was 52% (103 out of 197 donors). Types of donor infection included isolated contamination of preservation fluids (n = 30, 29.1%), graft colonization (n = 65, 63.1%) and bacteremia (n = 8, 7.8%). Donor-to-host transmission of bacterial or fungal infection occurred in 15 lung allograft recipients, 7.6% of lung transplants performed. Among these cases, 2 were due to donor bacteremia and 13 to colonization of the graft. Twenty-five percent of donors with bacteremia and 14.1% of colonized grafts were responsible for transmitting infection. Excluding the five cases without an effective prophylactic regimen, prophylaxis failure occurred in 11 out of 197 procedures (5.58%). Donor-to-host transmission of infection is a frequent event after lung transplantation. Fatal consequences can be avoided with an appropriate prophylactic antibiotic regimen that must be modified according to the microorganisms isolated from cultures of samples obtained from donors, grafts, preservation fluids and recipients.
本研究的目的是评估肺移植供体中细菌和真菌感染或污染的发生率及病因，并评估这些感染的供体-宿主传播情况。对存活超过24小时的受者及其各自的供体进行了评估。供体感染的总体发生率为52%（197名供体中有103名）。供体感染类型包括保存液单纯污染（n = 30，29.1%）、移植物定植（n = 65，63.1%）和菌血症（n = 8，7.8%）。15例肺移植受者发生了细菌或真菌感染的供体-宿主传播，占所进行肺移植手术的7.6%。在这些病例中，2例是由于供体菌血症，13例是由于移植物定植。25%的菌血症供体和14.1%的定植移植物导致了感染传播。排除5例无有效预防方案的病例后，197例手术中有11例发生预防失败（5.58%）。感染的供体-宿主传播在肺移植后是常见事件。通过适当的预防性抗生素方案可避免致命后果，该方案必须根据从供体、移植物、保存液和受者获得的样本培养物中分离出的微生物进行调整。
