Infectious Disease Screening of Living Kidney and Liver Donors at a Large Transplant Center
Infectious Diseases, University of California, San Francisco, CA
Transplant Surgery, University of California, San Francisco, CA
Meeting: 2013 American Transplant Congress
Abstract number: 498
Background: Screening practices for infection in potential living kidney and liver donors have not been standardized among transplant centers despite rare but potentially life-threatening transmitted infections. Controversy exists regarding the type, timing and frequency of tests. We aimed to report the feasibility and performance characteristics of our protocol, consisting of both serologic and nucleic acid testing (NAT), by investigating the incidence of positive screening tests within two weeks of transplant.
Methods: We performed a retrospective review of all living donors who underwent kidney or liver transplantation (KLT) from May 2008 to July 2012. Donors were included if at least two sets of screening tests were performed, with the second set obtained within two weeks of planned surgery. We evaluated the frequency of positive results within two weeks of transplant among tests that would potentially delay surgery. These consisted of human immunodeficiency virus (HIV), Hepatitis B surface antigen (HBsAg), Hepatitis B core antibody (HBcAb), Hepatitis C antibody (HCV), Human T-lymphotropic virus I and II antibody (HTLV), West Nile virus nucleic acid test (WNV), Trypanosoma cruzi antibody (TCA), and rapid plasma reagin (RPR).
Results: A total of 546 living donors underwent KLT between May 2008 and July 2012. Of these, 457 met inclusion criteria (421 kidney, 36 liver). Median period between date of first and second set of tests was 126 days (interquartile range 71-208 days). The following results occurred within two weeks of planned surgery. Rate of false positivity was 0.2% (1/425) for Hepatitis C NAT, 0.2% (1/456) for HCV, 0.4% (2/440) for TCA, and 0.4% (2/454) for HTLV tests. Among HBcAb tests, 3/454 (0.6%) were positive, but all were associated with positive HBsAb and negative HbsAg results. Even when selected repeat confirmatory tests were performed within the two-week window, transplants proceeded without delay.
Conclusions: The incidence of seroconversion between the two sets of screening tests, in addition to isolated positive tests within two weeks of transplant were low. The results of this study demonstrate the feasibility of a protocol consisting of baseline serologic screening tests for HIV, HBV, HCV, HTLV, syphilis, followed by repeat tests, including NAT for selected diseases, within a two week period prior to KLT in potential living donors.
To cite this abstract in AMA style:
Kim J, Freise C, Chin-Hong P. Infectious Disease Screening of Living Kidney and Liver Donors at a Large Transplant Center [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/infectious-disease-screening-of-living-kidney-and-liver-donors-at-a-large-transplant-center/. Accessed May 17, 2025.« Back to 2013 American Transplant Congress