Screening recipients of increased-risk donor organs: a survey of transplant infectious diseases physician practices.

BACKGROUND

In 1994, the Public Health Service published guidelines to minimize the risk of human immunodeficiency virus (HIV) transmission and to monitor recipients following the transplantation of organs from increased-risk donors. A 2007 survey revealed the post-transplant surveillance of recipients of organs from increased-risk donors (ROIRD) is variable.

METHODS

An electronic survey was sent to transplant infectious diseases physicians at US solid organ transplant centers.

RESULTS

A total of 126 surveys were sent to infectious diseases physicians, and we received 51 (40%) responses. We found that 22% of respondents obtain only verbal, 69% verbal and written, and 8% do not obtain any special consent from ROIRD, despite an Organ Procurement and Transplantation Network policy requiring such consent. Post-solid organ transplantation serologies for HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) are performed by 6-8% of respondents in all recipients, by 69% of respondents in ROIRD only, and 25% of respondents do not perform them at all. Post-transplant nucleic acid testing is carried out by 55-64% of respondents in ROIRD, by 0-2% in all recipients, and not performed by 35-43% of respondents.

CONCLUSION

Screening RIORD for HIV, HBV, and HCV has increased since 2007, but remains less than optimal and is incomplete when screening for disease transmission at many centers.