The OPTN DTAC, a multidisciplinary committee, evaluates potential donor derived transmission events (PDDTE), including mostly infections (I) & malignancies (M), to assess for likelihood of donor transmission events.

Methods: Between 7/1/15 – 6/30/16 the OPTN received 243 unexpected PDDTE reports, 212 were reviewed by DTAC. A standardized classification algorithm was used for each donor and individual recipients of reported donors.

Results: 24/212 donors had proven/probable (P/P) transmission of I, M or other conditions to 37/655 recipients. One report involved a living donor, resulting in a transmitted malignancy. 17/159 potential infection events were classified as P/P affecting 25 recipients. Bacteria were most frequently reported, and 10 recipients from 7 donors experienced P/P transmission, resulting in 2 deaths. HBV and HCV accounted for 16 reports; 8 recipients had P/P transmissions from 4 donors. Parasites accounted for 12 reports resulting in 1 infected recipient. Five donors with potential malignancy events were classified as P/P, with 10 impacted recipients and ultimately 6 attributable deaths. Four non-infection, non-malignancy PDDTE were also reported; two resulted in P/P transmissions and 1 death. Overall, 24 donors resulted in P/P transmission to 37 recipients including 15 kidney, 12 lung, 9 liver, and 1 each of kidney-pancreas, pancreas, heart and intestine when accounting for multi-organ transplants. Deaths secondary to infectious events occurred within the first 2 months of transplant, whereas deaths attributable to donor-derived malignancy occurred up to 5 years later.

Conclusions: Only 24 (11%) of the reported cases resulted in proven/probable transmissions; this remains low considering the number of annual transplants. Lung recipients appear disproportionately represented in this cohort and may have increased risk for donor-derived transmission events. Donor-derived malignancy remains uncommon but carries significant mortality. Continued evaluation of PDDTE allows for improved assessment of risk and hopefully preventative strategies.

CITATION INFORMATION: Wolfe C, Clark M, Tlusty S, Kaul D, Michaels M. Donor Derived Transmission Events in 2015-2016: Analysis of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC). Am J Transplant. 2017;17 (suppl 3).

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