Greenhall George H B, Robb Matthew L, Brown Chloe, Johnson Rachel J, Tomlinson Laurie A, Callaghan Chris J, Watson Christopher J E
Department of Statistics and Clinical Research, NHS Blood and Transplant, Bristol, United Kingdom.
School of Immunology and Microbial Sciences, King's College London, London, United Kingdom.
Transplantation. 2022 Mar 1;106(3):588-596. doi: 10.1097/TP.0000000000003792.
There is little evidence regarding the use of organs from deceased donors with infective endocarditis. We performed a retrospective analysis of the utilization, safety, and long-term survival of transplants from donors with infective endocarditis in the United Kingdom.
We studied deceased donor transplants over an 18-y period (2001-2018) using data from the UK Transplant Registry. We estimated the risk of infection transmission, defined as a microbiological isolate in the recipient matching the causative organism in the donor in the first 30 days posttransplant. We examined all-cause allograft failure up to 5 years in kidney and liver recipients, comparing transplants from donors with endocarditis with randomly selected matched control transplants.
We studied 88 transplants from 42 donors with infective endocarditis. We found no cases of infection transmission. There was no difference in allograft failure between transplants from donors with infective endocarditis and matched control transplants, among either kidney (hazard ratio, 1.48; 95% CI, 0.66-3.34) or liver (hazard ratio, 1.14; 95% CI, 0.54-2.41) recipients. Compared with matched controls, donors with infective endocarditis donated fewer organs (2.3 versus 3.2 organs per donor; P < 0.001) and were less likely to become kidney donors (odds ratio, 0.29; 95% CI, 0.16-0.55).
We found acceptable safety and long-term allograft survival in transplants from selected donors with infective endocarditis in the United Kingdom. This may have implications for donor selection and organ utilization.
关于使用患有感染性心内膜炎的已故供体器官的证据很少。我们对英国患有感染性心内膜炎的供体移植器官的利用情况、安全性和长期存活率进行了回顾性分析。
我们利用英国移植登记处的数据，研究了18年期间（2001 - 2018年）已故供体的移植情况。我们估计了感染传播的风险，定义为移植后前30天内受者体内的微生物分离株与供体中的致病生物体匹配。我们检查了肾和肝受者长达5年的全因移植失败情况，将来自感染性心内膜炎供体的移植与随机选择的匹配对照移植进行比较。
我们研究了42名患有感染性心内膜炎的供体的88例移植。我们未发现感染传播病例。在肾（风险比，1.48；95%可信区间，0.66 - 3.34）或肝（风险比，1.14；95%可信区间，0.54 - 2.41）受者中，来自感染性心内膜炎供体的移植与匹配对照移植之间的移植失败率没有差异。与匹配对照相比，患有感染性心内膜炎的供体捐献的器官较少（每位供体2.3个器官对3.2个器官；P < 0.001），并且成为肾供体的可能性较小（优势比，0.29；95%可信区间，0.16 - 0.55）。
我们发现在英国，从选定的患有感染性心内膜炎的供体进行移植具有可接受的安全性和长期移植存活率。这可能对供体选择和器官利用有影响。
