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Organ transplantation from “increased infectious risk donors”: the experience of the Nord Italia Transplant program — A retrospective study
Authors:Paolo Antonio Grossi  Daniela Dalla Gasperina  Domenico Lombardi  Andrea Ricci  Giuseppe Piccolo  Alessandro Nanni Costa
Affiliation:1. Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy;2. Italian National Transplant Centre, Istituto Superiore di Sanità, Rome, Italy;3. Nord Italia Transplant Program, Ospedale Maggiore Policlinico‐IRCCS Ca Granda, Milan, Italy
Abstract:The purpose of this study was to assess the safety and the clinical outcome associated with organ transplantation from increased infectious risk donors (IRD). We retrospectively identified all adult deceased IRD referred to the Nord Italia Transplant program coordinating center from November 2006 to November 2011. All potential donors were screened for social risk factors that may increase the risk of donor‐derived infection with human immunodeficiency (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV). All recipients were followed monthly for the first 6 months post‐transplant. A total of 86 potential IRD were identified during the study period. Three hundred and seventy‐nine organs from IRD were offered to the transplant centers, but only 185 (48.8%) were used for transplantation. Organs from IRD were transplanted into 174 recipients. The complete follow‐up data were available for 152 of 174 (87.3%) recipients. During a mean follow‐up of 11.7 months (median 12; range 2.4–12), no transmission of HIV, HBV, or syphilis was documented by serology and nucleic acid testing (NAT) testing. Two patients transplanted with organs from HCV‐RNA‐positive donors, as expected, developed post‐transplant HCV infection. In conclusion, the use of organs from IRD was associated with a safe increase in the transplant procedures in our country.
Keywords:expanded donor pool  hepatitis C  increased infectious risk donors  infection  organ transplantation
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