Outcome of transplantation of organs procured from bacteremic donors.
BACKGROUND
Transplantation of organs from donors who are bacteremic is controversial. We examined the outcome of recipients of solid organs from donors with bacteremia and/or fungemia at the time of organ recovery.


METHODS
All organ donors from a single organ procurement organization between January 1990 and December 1996 were retrospectively analyzed. We calculated rates of transmission from bacteremic or fungemic donors to their recipients and compared the graft and patient survival rates for recipients of these organs with those for recipients of organs from non-bacteremic donors.


RESULTS
There were 95 (5.1%) bacteremic donors from a total of 1775, from whom 212 recipients received organs. Forty-six (48%) of the bacteremic donors had pathogens in their blood. Among the 101 recipients of organs from these, no evidence of transmission could be documented. (0% transmission rate, 95% CI 0-3). The remaining 49 donors had either Staphylococcus epidermidis or other unlikely pathogens recovered from the blood. Examination of the 111 recipients of organs from these donors also found no evidence for transmission (0% transmission rate, 95% CI 0-3). Of the 212 recipients, 193 (91%) received a mean of 3.8+/-2.5 days of antibiotics postoperatively. The 30-day graft and patient survival for recipients of organs from bacteremic donors was not significantly different from recipients of organs from nonbacteremic donors (P = 0.695 for patient survival, and P = 0.310 for graft survival).


CONCLUSIONS
Organs transplanted from bacteremic donors do not transmit bacterial infection or result in poorer outcomes. Use of organs from these donors could help increase organ availability.
Freeman
R B
RB
Department of Surgery, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
Giatras
I
I
Falagas
M E
ME
Supran
S
S
O'Connor
K
K
Bradley
J
J
Snydman
D R
DR
Delmonico
F L
FL
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia; D001424:Bacterial Infections / Q000517:prevention & control / Q000635:transmission; D005260:Female; D016469:Fungemia; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000517:prevention & control / Q000635:transmission; D016377:Organ Transplantation; D011182:Postoperative Care; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents