Abnormalities in CSF in deceased organ donors may suggest infection and lead to refusal of organs by transplant centers, particularly if a viral process is suggested. Occasionally CSF is obtained shortly after brain death, which is an inflammatory state that could in itself cause CSF abnormalities. The literature offers little guidance on this specific issue. We collected CSF in 10 non-infected, brain dead organ donors just before organ recovery was to begin (4 CVA, 2 traumatic, 4 anoxia). Routine testing for active bacterial and viral infection in these donors was negative, including serologies, cultures, and nucleic acid (NAT) testing for hepatitis B, C and HIV. Lumbar puncture was performed 2.7 +/- 1.3 days after admission. 22 organs were transplanted without evidence of transmission of disease to recipients.

In many noninfected donors, CSF findings suggested CNS infection. CSF glucose (range 17- 111 mg/dl) was low in 5 donors (26 +/- 10 vs. 79 +/- 23 mg/dl, mean +/- SD ). WBC in the CSF when corrected for RBC was elevated in 5 donors (34, 368, 498, 678, and 3500 /mm3). All donors had markedly elevated CSF protein, with 6 of 10 > 600 mg/dl. CSF LDH was elevated in 8 of 9 (1250 +/= 1125, range 394-3000 u/ml). These abnormalities did not associate with one another or with cause of brain death.

In summary, abnormalities in protein, WBC, and glucose in the CSF of brain dead non-infected organ donors are not uncommon and can falsely suggest infection. While every measure should be employed to rule out transmissible disease, these findings should not in themselves preclude organ donation.

CAUSE OF DEATH (COD) AND CSF AND BLOOD FINDINGS IN 10 BRAIN DEAD ORGAN DONORS:

CITATION INFORMATION: Steiner R, Wainaina C, Tragaser J, Stocks L. What Are “Normal” CSF Findings in the Non-Infected Brain Dead Organ Donor? Am J Transplant. 2017;17 (suppl 3).

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