Background: Despite a long wait-list, transplant physicians always weigh the benefit of transplantation against the risk of accepting a potentially infected solid organ with resultant serious complication to the recipient. Choices are to discard the organ based on risk of transmission or transplant the organ with a plan to control the potential infection. There is no standard approach utilized before organs are discarded based on any particular infection. We sought to review all the infection-related reasons for kidney discards in an effort to improve the wait-list for renal transplantation.
Methods: A retrospective review of the UNOS data from January 1, 2007 through March 31, 2012 was performed. Data were recorded on all kidneys discarded based on report of infection as the primary reason.
Results: 13998 kidneys were discarded from 8499 donors for various reasons. 463 kidneys (3.3%) were discarded for reasons related to infection. Five discrete fields were available in DonorNet to enter the following infection related discard reasons: CMV, Donor Social History, Hepatitis, HIV and Infection. Twelve additional reasons were cited under the category "Other". All reasons for kidney discards related to infection are summarized in figure 1.
Discrete fields in DonorNet captured 60.90% of discard reasons related to infection. The remaining 39.10% of reasons for discard related to infection were manually entered under "Other". Hepatitis accounted for 51.18% of all infection related reasons for kidney discard. This is followed by Infection 11.23%, Donor Social History 9.7%, Contamination 7.1% and CDC High Risk designation in 4.7%. CNS infection or meningitis was not mentioned as a reason for discard. Lack of detailed fields in DonorNet limited the proper tracking of discards related to infection.
Conclusions: Overall, kidney discard rates for infection related reasons are small. Standardization of criteria for organ discards is needed to improve optimal utilization of solid organs for transplantation.
To cite this abstract in AMA style:Malinzak L, Patel A, Kim D, Denny J, Weitzer M, Alangaden G, Ramesh M. Infection Related Kidney Discards [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/infection-related-kidney-discards/. Accessed January 27, 2021.
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