Elsevier

Transplantation Proceedings

Volume 37, Issue 9, November 2005, Pages 3664-3666
Transplantation Proceedings

Organ donation
Clinical consideration
Donors With Positive Blood Culture: Could They Transmit Infections to the Recipients?

https://doi.org/10.1016/j.transproceed.2005.08.053Get rights and content

Abstract

A retrospective analysis of data from January 1996 to June 2004 was performed to evaluate the transmission of bacterial infections from organ donors to recipients. Donors were classified according to blood culture results: group 1 with negative blood culture (n = 216), and group 2 with positive blood cultures (n = 52). The age, cause of death, temperature, leukocytes, and number of organs procured were similar in both groups. Donors of group 2 had significantly more days in the intensive care unit (ICU): group 1 (3.14 ± 3) versus group 2 (4.39 ± 3.38 days P = .038). Fifty-one percent of group 1 and 52% of group 2 received antibiotic treatment, in most cases because of the suspected presence of a respiratory infection. In 22 donors the organisms that yielded in the blood culture were considered potentially pathogenic/contaminants (subgroup 2A) and in 30 donors the organisms were considered pathogenic (subgroup 2B). The demographic profiles of these two subgroups were similar. During the first month after transplantation, kidney and liver recipients were closely monitored. Recipients received wide-spectrum antimicrobial prophylaxis. Ten of 61 renal recipients developed infectious diseases. In nine cases (four in subgroup 2A and five in subgroup 2B) there were urinary infections. One recipient of subgroup 2B developed prostatitis. Six of 34 hepatic recipients developed infectious diseases. Four of the six cases (four in group 2A and five in group 2B) developed catheter infections and two cases of peritoneal infections. We could not find any case where a bacterial blood isolate from a donor matched a positive culture in the corresponding recipient. A longer stay of a donor in the ICU resulted in the more pronounced growth of organisms in blood cultures, as expected. In our experience, organs obtained from a donor with a positive blood culture may be transplanted safely, probably due to the low virulence of the organisms as well as the polymicrobial therapy routinely given to the recipients.

Section snippets

Materials and methods

This study reflects the results of a retrospective analysis from January 1996 to June 2004. Serial blood samples, urine samples, and other samples from all donors were routinely obtained for culture before organ procurement. We studied 268 donors and classified them according to blood culture results: group 1, donors with negative blood culture (n = 216) versus group 2, donors with positive blood culture (n = 52).

All donors with positive blood cultures were included in this analysis, regardless

Results

Fifty-two of 268 donors showed bacteremia and 216 did not. Group 1 donors did not differ from group 2 with regard to age, cause of death, temperature, leukocytes, and type of harvested organs. Group 2 donors had stayed significantly more days in the intensive care unit (ICU): group 1 (3.14 ± 3) versus group 2 (4.39 ± 3.38 days; P = .038).

One hundred eleven group 1 donors (51.3%) and 27 group 2 donors (51.9%) had received antibiotic treatment. Amoxyclavulanic acid was administered to 80% group 1

Discussion

Recently, some authors have suggested that potential individuals with positive blood cultures can be considered to be viable donors and that their organs can be transplanted safely.1, 2, 3, 4 Donors with sepsis and multiorganic failure at the moment of organ procurement or donors infected with multiresistant organisms would be the exceptions.

In our study, upon careful review, we could find no case where a bacteria isolated from the blood of a donor matched a positive culture in the

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