Introduction. The study aim was to determine microbiological characteristics of preservation fluid (PF) cultures in solid organ transplant (SOT) patients and to evaluate their impact on mortality and morbidity.

Methods. A retrospective analysis of PF culture data for SOT recipients was performed between November 1, 2013 and November 1, 2014. Deceased donor culture data and PF was collected from the UNOS database. Additional PF culture data was obtained locally immediately upon organ arrival to the operating room.

Results. Analysis of data from 69 SOT recipients (Kidney 69.5%, Kidney-Pancreas 11.5%, Pancreas 7%, and Liver 12%) revealed 19 (27.5%) positive deceased donor cultures and 43 (62.3%) PF cultures. Microbial agents isolated from PF were coagulase-negative staphylococci (52.3%) Diphtheroids (39.5%), Staphylococcus spp., Pseudomonas spp., and yeast (all 9.3%). Three patients (4.3%) had same microorganism in deceased donor and PF culture. Of the 49 patients with positive cultures (either PF or deceased donor cultures), 21 (42.8%) received pre-emptive antibiotic therapy within 48 hours.

One renal transplant patient developed invasive Pseudomonas infection in the urine related to the deceased donor cultures. There were no other incidences of invasive infections related to the microorganisms isolated in deceased donor culture or PF culture regardless of administration of pre-emptive antibiotic therapy. Mortality rates at both 30 days and 90 days were not significantly different in recipients with positive or sterile PF cultures (30 days: 1 [2.3%] vs. 0 [0%], p=1; 90 days: 2 [4.6%] vs. 0 [0%], p=0.52). Rates of transplant graft loss at 30 days were also not significantly related to the rates of positive or sterile PF cultures (6 [13.9%] vs. 0 [0%], p=0.07).

Conclusion. Microbial contamination during solid organ transplantation occurs frequently. Although rates of mortality and morbidity remain low, virulent organisms such as Pseudomonas spp. can cause serious infections. Fatal consequences due to invasive infection can be avoided with appropriate and timely surveillance of microorganisms isolated from cultures of samples obtained from donors, grafts, and preservation fluid.

CITATION INFORMATION: Nam H, Perni N, Galen K, Campara M, Roca-Garcia R, Yeldandi V. Significance of Preservation Fluid Cultures in Solid Organ Transplantation. Am J Transplant. 2016;16 (suppl 3).

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