*Purpose: In the US, deceased donor screening for Strongyloides started in 2010. By 2013 10% of the OPOs had implemented screening practices. Recipients of sero-positive organs receive ivermectin prophylaxis. The objective of this study was to determine the trend in Strongyloides case adjudications by the DTAC in the era of increased donor screening.

*Methods: A retrospective cohort study of potential donor derived Strongyloides transmission events (PDDTE) adjudicated by DTAC from 2008-2017. Events are reported due to disease in a recipient or a positive result in donor screening. A standardized classification algorithm was used to adjudicate each event. Year-by-year differences in the proportion of adjudicated cases were evaluated by the Cochran-Armitage trend test.

*Results: 60 PDDTE were reviewed during the study period. 13 of them were deemed not a PDDTE (7 due to recipient disease reactivation; 6 due to false positive donor serology). 15 donors transmitted Strongyloides; none were screened and most had epidemiologic risks (Figure 1). Of 43 recipients from those donors, 19 developed proven or probable (P/P) disease (44.2%). The 45-day mortality for P/P cases was 26.3%, all attributable to Strongyloides. No recipients that received prophylaxis developed P/P disease. During the study period the proportion of events initiated due to a positive Strongyloides screening test increased over time and the proportion of cases adjudicated as P/P decreased (Figure 2 and 3) (Cochran-Armitage trend test < 0.01 respectively).

*Conclusions: During the study period the proportion of reports initiated due to a positive result on a screening Strongyloides test increased and the proportion of cases adjudicated as P/P decreased. This has occurred in temporal association with increased donor screening and effective recipient prophylaxis.

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