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Pediatrics & Donor Derived Disease Transmission: The US OPTN Experience

M. Green,1 S. Taranto,2 S. Covington,2 M. Michaels,1 C. Wolfe,3 D. Kaul.4

1Pediatrics & Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA
2OPTN/UNOS, Richmond, VA
3Medicine, Duke University School of Medicine, Durham, NC
4Medicine, University of Michigan School of Medicine, Ann Arbor, MI.

Meeting: 2015 American Transplant Congress

Abstract number: 22

Keywords: Donation, Infection, Malignancy

Session Information

Session Name: Concurrent Session: Donor-Derived Infection/Lifestyle/Tourism/Vaccines

Session Type: Concurrent Session

Date: Sunday, May 3, 2015

Session Time: 2:15pm-3:45pm

 Presentation Time: 2:39pm-2:51pm

Location: Room 115- AB

Potential donor derived disease transmission events (PDDTE) are tracked by the OPTN DTAC. Specific evaluation of potential transmissions from pediatric (ped) donors or the impact of donor derived disease transmissions to ped organ recipients has not been undertaken.

Methods: PDDTE reported between 2008-2013 were reviewed & characterized as proven, probable, possible, intervention without disease transmission (IWDT), unlikely or excluded for the whole case & for individual recipients. Ped donors & recipients were 0-17 years of age. Analysis characterized potential transmissions from peds donors to adult or ped recipients & potential transmissions from all donors to ped recipients. Proven & Probable (P/P) cases were further analyzed.

Results: 5238 ped donors accounted for 17,470 organ transplants during the study period. 103 PDDTE reports arose from these donors (2.0%) & were characterized as P/P (15%), possible (11%), IWDT (9%), unlikely (4%) & excluded (61%). Disease was transmitted to 22/54 potentially exposed (adult & ped) recipients with 6 attributable deaths. Infectious pathogen accounted for 13/15 of P/P PDDTE associated with ped donors, affecting 19/50 potentially exposed recipients resulting in 5 deaths. 4 viral pathogens accounted for 6 P/P transmissions with unanticipated transmission of CMV most common. No ped donor transmitted HIV, HBV or HCV. Bacteria, fungi & parasites accounted for 3 (all staph), 2 (Zygomycetes & Histoplasma) & 2 (both Toxoplasma) transmissions, respectively. From the recipient side, 11/11,187 ped recipient transplants during the study period were associated with P/P PDDTE (< 0.1%) with infectious pathogens accounting for 9/11 P/P events including bacteria (2), viruses (3), parasites (3) & fungi (1).

Conclusions: Reporting rates of PDDTE involving ped donors were very low & similar to rates from all donors with resulting P/P transmissions occurring in only 0.1% of exposed recipients but were associated with 6 deaths. Rates of P/P transmission to ped recipients from any donor (< 0.1%) were also very low & similar to that of all recipients. Additional studies are needed to compare the pattern & outcome of donor derived disease transmission from & to ped & adult donor & recipients.

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To cite this abstract in AMA style:

Green M, Taranto S, Covington S, Michaels M, Wolfe C, Kaul D. Pediatrics & Donor Derived Disease Transmission: The US OPTN Experience [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/pediatrics-donor-derived-disease-transmission-the-us-optn-experience/. Accessed May 11, 2025.

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