Feijó Mateus Silva, Galdino-Vasconcelos Mayara Regina, Simões Viviann, Atik Fernando, Castro Fabíola F S, Ferreira Gustavo, Jorge Fernando, Diaz Luiz Gustavo, Brizolla de Campos Priscila, Trevizoli Natália, Cajá Gabriel, Ullmann Raquel, Watanabe André
Faculty of Medicine, University of Brasilia, Brasilia, Brazil.
Faculty of Medicine, University of Brasilia, Brasilia, Brazil.
Transplant Proc. 2020 Jun;52(5):1236-1242. doi: 10.1016/j.transproceed.2020.02.027. Epub 2020 Mar 23.
In the era of shortage of organs for donation, transplantation from suboptimal donors is an expanding alternative to minimize waitlist mortality. In that sense, the safety of using organs from bacteremic donors has been a recurrent matter of discussion. We aimed to evaluate the influence of donor positive blood culture in the recipient and graft outcomes after liver transplantation from deceased donors.
Blood culture results from 255 deceased liver donors were retrospectively reviewed. Patients were categorized into 2 groups based on the recipients who obtained a graft from a donor with negative or positive blood culture. Graft and recipient outcomes were compared between the 2 groups using univariate survival analysis and multivariate regression models. Transmission of bloodstream infection from donor to recipient was assessed by reviewing recipients' microbiologic status when there was evidence of infection.
Positive blood culture in donors was not associated with negative outcomes after transplantation. Death within 30 days after transplantation and overall recipient and graft survival did not differ between the 2 groups. Only Child-Pugh score ≥10 and retransplantation status were considered independent predictors of recipient death and graft failure. We identified 1 potential case of bacteremia transmission from donor to recipient.
Donor positive blood culture was not associated with negative outcomes after liver transplantation. Transmission of infection from donor to recipient is possible, but rare. The results support the usage of bacteremic donors as a safe alternative to the scarcity of optimal donors.
在器官捐赠短缺的时代，使用次优供体进行移植是减少等待名单上死亡率的一种不断扩大的替代方法。从这个意义上说，使用菌血症供体器官的安全性一直是反复讨论的问题。我们旨在评估供体血培养阳性对已故供体肝移植后受者和移植物结局的影响。
回顾性分析255例已故肝供体的血培养结果。根据接受来自血培养阴性或阳性供体移植物的受者将患者分为两组。使用单变量生存分析和多变量回归模型比较两组之间的移植物和受者结局。当有感染证据时，通过回顾受者的微生物学状态来评估供体向受者的血流感染传播情况。
供体血培养阳性与移植后的不良结局无关。两组在移植后30天内的死亡率以及总体受者和移植物生存率无差异。只有Child-Pugh评分≥10和再次移植状态被认为是受者死亡和移植物失败的独立预测因素。我们确定了1例供体向受者菌血症传播的潜在病例。
供体血培养阳性与肝移植后的不良结局无关。供体向受者的感染传播是可能的，但很罕见。这些结果支持将菌血症供体作为最佳供体稀缺时的一种安全替代方法。
