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CDC: Protect Organ Transplant Patients from Unintended Disease Transmission

Posted on by CDC's Safe Healthcare Blog
Matthew J. Kuehnert, MD
Matthew J. Kuehnert, MD

Author: Matthew J. Kuehnert, MD,
Director, Office of Blood, Organ, and Other Tissue Safety

Over the past few years, my team at the CDC looked into more than 200 reports of unexpected disease transmission through organ transplantation. Of the cases that were confirmed, some had fatal outcomes. Clearly, transmission of infections through organ transplants remains a patient safety concern that calls for action.

To help address the problem, CDC recently led a team of experts to develop the Draft 2011 Public Health Service (PHS) Guideline for Reducing Transmission of HIV, HBV, and HCV through Solid Organ Transplantation. The guideline was posted to the Federal Register today, and I encourage your review and comment.

While recognizing the critical need for organs, our team also wants to ensure recipients are protected from getting unexpected diseases from the organs they receive. After taking a critical, unbiased look at the best available science, I believe recommendations in the draft guideline will save lives and reduce unintended disease in organ recipients. Specific recommendations include improved donor screening practices and better organ testing procedures that will allow patients and their doctors to make more informed risk/benefit decisions about available organs.

I encourage you to review the draft guideline, share it with others who may be interested, and submit comments during the 60-day public comment period.

Please visit these additional websites for more information:

Posted on by CDC's Safe Healthcare Blog

4 comments on “CDC: Protect Organ Transplant Patients from Unintended Disease Transmission”

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    Thank you for the comments. I agree that the focus should always be on the best outcome for the patient. It’s important to keep in mind that a positive test should not prevent an organ to be given to a recipient in urgent need. For instance, the draft guidelines outline situations where organs from a donor positive for hepatitis B or C could be transplanted to recipients, and urge research to be conducted on the potential benefit of the use of organs from known HIV positive donors – particularly for recipients who are already HIV positive. In dire situations, organs can be transplanted even before testing is available. In the end, it should be up to the patient, in consultation with their transplant team, to decide whether it is worth the risk to accept that organ. Hopefully, for all the recommendations, the guidelines will help patients and their doctors to make the best decisions possible.

    Matthew J. Kuehnert, MD
    CAPT, U.S. Public Health Service
    Centers for Disease Control and Prevention (CDC)

    It has now been established by published studies that the risk of disease is significantly higher for organ donors than for either tissue or blood donors. The concern for false positive NAT is a real one due to the possible loss of donors. However, unlike for blood donors, subjective analysis of test results can often distinguish between true positive and false positive tests allowing the surgeon greater latitude in the decision process. greater attention also need to be place on the substantial loss of acceptable organs that have been recovered but are lost due to process and logistical errors. Ultimately, we are all interested in improving access and patient outcomes.

    As a transplant professional I support the principle that every attempt should be made to minimise the risk of disease transmission via transplanted organs. However that risk will never be 0% due to the nature of transplantation-i.e. short time frames to assess deceased donors noting that the donor is not able to corroborate their own medical and social history. Although NAT testing is effective every false positive NAT test result obtained will prevent the use of life saving organs from the deceased donors where this occurs.

    There have been publications in the US Transplant literature on this same issue with a consensus report in the American Journal of Transplantation, 2010, 10, 889-899 and a report on disease transmission from Ison & Nalesnik, Am J Transpl 2011, 11. 1123-1130. I trust that CDC will engage with UNOS, AST and ASTS on this important issue

    I like this post very much. I extend my extreme gratitude for all those behind this blog. please keep me posting any new information. Thank You.

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