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Committee Analysis of Donor-Transmitted Disease Featured in American Journal of Transplantation

Along with the life-saving and life-enhancing benefits of organ transplantation, there is always some risk that a disease present in the donor can be conveyed to recipients. The OPTN/UNOS Ad Hoc Disease Transmission Advisory Committee (DTAC) investigates reports of potential disease transmission from donor to recipient, both to better estimate the risk of transmission and to recommend measures either to reduce the future risk or to improve treatment of recipients with a donor-derived disease.

In the August 2009 edition of the American Journal of Transplantation, the DTAC, for the first time, summarized its investigation of reports of potential donor-derived transmission events in the United States. The article chronicles events reported from 2005 (the first full year such data were collected) through 2007.

Reporting of potential events continued to increase each year of the study period; this likely was not an indication of higher rates of disease transmission but an improvement in reporting. Because more specific classification was available for the 2007 reports, the analysis focused on that year in greatest detail.

The overall frequency of reports of potential disease transmission was very low, accounting for 0.96 percent of all deceased donation in 2007. In most reports, either transmission could not be proven or there was no reported illness in a recipient. However, a significant proportion of proven transmission events resulted in death or illness among transplant recipients. Given that multiple organs can be transplanted from the same deceased donor, multiple recipient outcomes could be linked to the same donation event.

The analysis identified seven proven malignancy transmissions from deceased donors in 2007. In the same year there were five proven and two probable donor-derived infectious disease transmissions. Nine reported deaths were attributable to eight proven cases of donor transmission events during 2007.

The authors caution that the true incidence of donor-transmitted disease is not yet known, but improvements in reporting and following such cases should clarify the risk over time. The DTAC is actively working to educate the transplant community about identifying and reporting potential events and enhancing its methods of analysis.

To view the entire article, consult the following citation:

M.G. Ison et al. Donor-Derived Disease Transmission Events in the United States: Data Reviewed by the OPTN/UNOS Disease Transmission Advisory Committee. American Journal of Transplantation 2009; 9: 1929-1935.