Corman Dincer Pelin, Tore Altun Gulbin, Birtan Deniz, Arslantas Reyhan, Sarici Mert Nurcan, Özdemir Ihsan, Arslantas Mustafa Kemal
Anesthesiology and Reanimation Department, Marmara University, School of Medicine, Istanbul, Turkey.
Anesthesiology and Reanimation Department, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.
Transplant Proc. 2019 Sep;51(7):2195-2197. doi: 10.1016/j.transproceed.2019.03.054. Epub 2019 Aug 1.
Organ donation shortage is the primary barrier to all organ transplantations.Infectious disease transmission through transplantation is considered controversial for organ retrieval. Donors with bacteremia and sepsis are considered controversial for organ retrieval due to potential transmission of an infectious agent to the recipient.
We retrospectively reviewed the results of bacterial culture of the donor's blood from peripheral venous or central venous catheter, urine, and bronchial aspiration from the organ donation registries of 102 potential donors from the Ministry of Health and Tissue Transplant Coordination Center of Istanbul Region in 2015.
Of the 102 deceased donors included in the analysis, 24 (23.5%) had infection. The most common sites of infection were the bloodstream (41.6%) and the respiratory system (37.5%). The most common isolated pathogens of the bacterial cultures were Gram-positive bacteria (21), Gram-negative microorganisms (14), and Candida (1). The significant risk factor for infection was duration of stay at the intensive care unit (median: 5 day; 25-75%: 3-5 day) (odds ratio, 2.94; 95% confidence interval, 1.06-8.12; P < .05). The presence of infection in the donor accounted for a significant part of the reasons why the organs were not accepted for transplantation (kidneys 9%, liver 4%, heart 6%).
The study showed that deceased donors with prolonged stays in the intensive care unit have an increased risk for developing nosocomial infections; so there is a need for establishing and enforcing the prevention and control of infection in possible donors.
器官捐赠短缺是所有器官移植的主要障碍。通过移植传播传染病在器官获取方面存在争议。患有菌血症和败血症的捐赠者由于可能将感染源传播给接受者，在器官获取方面存在争议。
我们回顾性分析了2015年来自伊斯坦布尔地区卫生部和组织移植协调中心的102名潜在捐赠者的器官捐赠登记处中，捐赠者外周静脉血或中心静脉导管血、尿液及支气管吸出物的细菌培养结果。
纳入分析的102名已故捐赠者中，24名（23.5%）发生了感染。最常见的感染部位是血流（41.6%）和呼吸系统（37.5%）。细菌培养中最常见的分离病原体是革兰氏阳性菌（21株）、革兰氏阴性微生物（14株）和念珠菌（1株）。感染的显著危险因素是在重症监护病房的停留时间（中位数：5天；25%-75%：3-5天）（比值比，2.94；95%置信区间，1.06-8.12；P<0.05）。捐赠者存在感染是器官未被接受用于移植的重要原因之一（肾脏9%，肝脏4%，心脏6%）。
该研究表明，在重症监护病房停留时间延长的已故捐赠者发生医院感染的风险增加；因此，有必要在可能的捐赠者中建立并实施感染预防与控制措施。
