Date: Tuesday, June 14, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Intro: The OPTN DTAC evaluates potential donor derived transmission events (PDDTE), including infections & malignancies, to assess for donor transmitted events.
Methods: Reports of unexpected PDDTE to OPTN were reviewed from 1/1/06-9/8/15. We utilized a standardized algorithm for classification
Results: 157 cases were reported in 2006-07, but data was incomplete for further analysis. From 1/1/08-9/8/15 DTAC reviewed 1420 PDDTE (967 infection, 386 malignancy, 67 other). Of these, 154/967 (16%) infections and 54/386 (14%) malignancies had proven/probable (P/P) transmission to at least one recipient. 188/479 (39%) exposed recipients developed infection; 55/122 (45%) exposed recipients developed malignancy. 42/188 (22%) of infected recipients died, and 26/55 (47%) with donor-transmitted malignancy died. Renal cell cancer was the most commonly reported cancer 135 (35%) but with only 5 transmissions and 1 death. Lung cancer was the leading cause of death from malignancy with 9 deaths among 16 exposed recipients. Among infections, Coccidiomycosis caused the most deaths. 67 non-malignancy non-infection PDDTE with 11 transmissions and 3 deaths were reported. Overall, 211/63382 (0.33%) deceased donors transmitted disease with 249/174388 (0.14%) of total recipients developing donor derived disease. 71/174338 (0.04%) recipients died from donor derived disease.
Conclusions: Donor-derived disease remains rare, but outcomes can be poor. Recipients exposed to a donor with viral infection or malignancy are more likely to develop disease, and individuals with donor transmission of malignancy or parasitic infection are more likely to have fatal outcomes. Analysis of DTAC data will allow us to design optimal strategies to recognize and prevent donor derived disease.
|Total Reports||P/P Donors||Total Recipients From P/P Donors||Total Recipients with Transmission*||Total Deaths from Disease Transmission**|
|Malignancy||386||54||122||55 (45%)||26 (47%)|
|Bacteria||326||47||142||49 (35%)||8 (16%)|
|Mycobacteria||95||6||23||6 (26%)||1 (17%)|
|Fungus||179||34||117||41 (35%)||13 (32%)|
|Virus||291||42||117||61 (52%)||10 (16%)|
|Parasite||76||25||80||31 (39%)||10 (32%)|
|Other||67||11||35||11 (31%)||3 (27%)|
|Total||1420||219||636||254 (40%)||71 (28%)|
*%=recipients with transmission/recipients from P/P donors
**%=deaths from disease transmission/total recipients with disease transmission.
CITATION INFORMATION: Kaul D, Tlusty S, Wilk A, Wolfe C. A Decade of Donor-Derived Disease: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC). Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Kaul D, Tlusty S, Wilk A, Wolfe C. A Decade of Donor-Derived Disease: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC). [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/a-decade-of-donor-derived-disease-a-report-of-the-optn-ad-hoc-disease-transmission-advisory-committee-dtac/. Accessed July 21, 2018.
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