Background: In the UK, the Advisory Committee on Microbiological Safety of Blood, Tissues and Organs recommends discretionary T. cruzi antibody screening of donors with identified risk factors for American trypanosomiasis. Centralised T. cruzi screening of deceased organ donors was introduced by the organ procurement organisation in October 2014. In England, blood donors have been tested on a discretionary basis since 2009, with a current incidence of 0%.

Aims: To describe assessment of donor risks for Chagas disease in a non-endemic country and report results of donor screening implementation.

Methods: Indication for testing is identified through interview with next of kin (NoK) and medical history obtained from the donor's general practitioner. Requests submitted for T. cruzi Ab from deceased organ donors in England, N Ireland and Wales between Oct 2014 – Nov 2016 were reviewed for data collection. Bio kit Chagas Antibody® initially and then Abbott Architect Chagas ® assays were used as per manufacturer's instructions.

Results: Risk of exposure to T. cruzi was identified in approximately 77 / 4500 consented deceased organ donors (1.69%), a higher proportion than that seen amongst blood donors in England (0.07%). The distribution was as follows: Donor (19%) or donor's mother (3.9%) born in an endemic country, lived in an endemic country (9.1%) or visited an endemic area for > 4 weeks (68%). There were no seropositive results.

Discussion: Identification of risk is based largely on demographic and travel information obtained from the NoK at the time of donation, which is less precise when compared to live donor history, resulting in a lower specificity of selection. True risk of infection is associated with distinctive factors and prolonged exposure in rural, endemic or hyper endemic areas; donor or family history of conditions compatible with Chagas disease may also be present and must be noted. The risk of T. cruzi in our donor population remains very low, reflecting the representation of migrant populations in the UK donor pool. The commonest indication for testing is travel to endemic areas, whereas the higher risk indicators are seen in 30% of those tested. In this setting, emphasis has been on detailed donor history, with immediate post-donation screening as identification of infected donors at this stage will still inform modified recipient management and allow mitigation of morbidity.

CITATION INFORMATION: Ushiro-Lumb I, Webster M, Kitchen A. Identifying Risks and Screening Deceased Organ Donors in the UK for Trypanosoma cruzi . Am J Transplant. 2017;17 (suppl 3).

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