Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Limited organ supply is one of the major challenges facing organ transplantation. Donor-derived multidrug-resistant (MDR) bacteria have been documented with variable outcomes. In Saudi Arabia, the prevalence of multidrug-resistant related infection is considerably high which raises concerns about transmitting the infection to recipients. We aimed to study the prevalence of positive cultures from deceased donors and the risk of donor-derived infection at King Faisal Specialist Hospital and Research Centre (KFSH&RC).
Retrospective cohort study between January 1st 2012 to December 30th 2018 of all deceased donors’ transplantation at KFSH&RC. Donors cultures, colonization status, recipients’ pre and post- transplant cultures, colonization status, CMV and EBV sero-status, antimicrobial treatment, rejection episodes and mortality data were collected.
*Results: This is an interim analysis of 379 donors and recipients (one recipient per donor). Data on the cultures from clinical samples are included in this abstract. The majority of donors (68%) had positive cultures. Isolation of MDR bacteria was documented in 35% of the donors. The most common isolated MDR pathogens isolated was carbapenem-resistant gram negative CR-GNR (83.5%). Among MDR gram negative, carbapenem-resistant Acinetobacter baumannii (CR-ACB) was the commonest isolated pathogen (70.3%) followed by CR- Klebsiella pneumoniae and CR-Pseudomonas aeruginosa (13.18%). This was followed by Vancomycin resistant Enterococcus (19%). CR-ACB was isolated most commonly from the respiratory cultures of the donors. The majority of recipients (74.6%) had negative microbiology results prior to transplantation. On the other hand, 50% of the recipients had infection events post-transplantation. Of those, 46% had MDR pathogens related infections and 95.8% of the infections were secondary to CR-GNR. Isolation of CR-ACB from donors’ culture was associated with significantly increased risk for ACB related infection in the recipients (RR 8.15 95% CI 1.5280 to 43.8615 P=0.0141). based on this interim analysis, the mortality rate was not different between the recipients who received organs from infected donors compared with recipients who received organs from non-infected donors (RR 1.1 95% 0.7833 to 1.5565 P = 0.5715).
*Conclusions: Rate of transmission of bacterial infection from deceased donors to recipient appears to be high but did not increase the risk for mortality
To cite this abstract in AMA style:Almaghrabi RS, Alameer R, Zeitoni O, Ahmed M, Nizami I, Alburaiki J, Aljurf T, Alyamany R, Abed A, Broering D. High Rate of Positive Cultures from Deceased Donors, A Review of 500 Deceased Donors and More Than 700 Recipients from a Single Center in Saudi Arabia [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/high-rate-of-positive-cultures-from-deceased-donors-a-review-of-500-deceased-donors-and-more-than-700-recipients-from-a-single-center-in-saudi-arabia/. Accessed November 24, 2020.
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