*Purpose: In Europe, vigilance monitoring after organ transplant includes Serious Adverse Events (SAE) as well as Serious Adverse Reactions (SAR). All SAE and SAR related to deceased organ donors from Germany and recipients in Germany have to be reported to the national competent authority for further evaluation. SAE describe delayed findings in the donor or in donor substances after transplant that pose a certain risk of harm to the already transplanted recipients of this specific donor, e.g. previously undetected donor infections. SAR refer to harm that has occurred to one or more recipients of the same donor and that is suspicious of being associated with the donor organ, e.g. new HCV infection in a recipient.

*Methods: Analysis of all reported SAE/SAR regarding infections from 1/2016 to 12/2017 associated to German organ donors and/or recipients.

*Results: 52 donor-associated pathogens (SAE) were detected after shipment in different samples: donor blood (5), swabs (6), bronchioalveolar lavage (BAL/14), not-transplanted organs (2) or organ transport fluid (25). The pathogens were bacterial (43 incl. 6 multidrug resistant (MDR) and one Mycobacterium), fungal (7), viral (1 (HCV)) and one unidentifiable. One donor with occult HCV-infection transmitted HCV to all 5 recipients. These recipients were cured by immediate therapy. In addition 1 VRE was found in a pancreas recipient and 1 C. albicans in a kidney recipient. None of the other pathogens have been shown to be transmitted to any of the recipients. From donors outside Germany, 30 donor pathogens have been reported as SAE: bacterial (25 incl. 5 Acinetobacter baumanii and one M. tuberculosis), fungal (3), viral (2) without transmission to German recipients. Regarding SAR without previous SAE reporting, 17 pathogens were described to cause suspected donor-transmitted infections: bacterial (5), viral (5), fungal (4, one of them from a foreign donor) and undetermined sepsis (2). 3 of those were confirmed/probable to be of donor origin (Bornavirus/3 recipients/2 deceased; 2 Candida species/2 recipients/alive), 4 were possibly of donor origin, 7 unlikely and in 2 cases donor origin was excluded.

*Conclusions: Previously undetected and transmissible donor infections may be the cause of fulminant and life threatening infections in donors. Therefore, detailed reporting and national and international analysis of SAE/SAR is crucial to to learn more about the risk of donor-derived infections and possible consequences on organ acceptance.

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