title: Nucleic acid testing (NAT) of organ donors: is the 'best' test the right test? A consensus conference report.
abstract: Nucleic acid testing (NAT) for HIV, HBV and HCV shortens the time between infection and detection by available testing. A group of experts was selected to develop recommendations for the use of NAT in the HIV/HBV/HCV screening of potential organ donors. The rapid turnaround times needed for donor testing and the risk of death while awaiting transplantation make organ donor screening different from screening blood-or tissue donors. In donors with no identified risk factors, there is insufficient evidence to recommend routine NAT, as the benefits of NAT may not outweigh the disadvantages of NAT especially when false-positive results can lead to loss of donor organs. For donors with identified behavioral risk factors, NAT should be considered to reduce the risk of transmission and increase organ utilization. Informed consent balancing the risks of donor-derived infection against the risk of remaining on the waiting list should be obtained at the time of candidate listing and again at the time of organ offer. In conclusion, there is insufficient evidence to recommend universal prospective screening of organ donors for HIV, HCV and HBV using current NAT platforms. Further study of viral screening modalities may reduce disease transmission risk without excessive donor loss.
authors.affiliation: Transplant Infectious Diseases, University of Alberta.
authors.forename: A
authors.initials: A
authors.lastname: Humar
authors.affiliation: Infectious Diseases, University of Miami Miller School of Medicine.
authors.forename: M
authors.initials: M
authors.lastname: Morris
authors.affiliation: Infectious Diseases, University of Pennsylvania.
authors.forename: E
authors.initials: E
authors.lastname: Blumberg
authors.affiliation: Tufts Medical Center.
authors.forename: R
authors.initials: R
authors.lastname: Freeman
authors.affiliation: Transplant Infectious Diseases, University of Alberta.
authors.forename: J
authors.initials: J
authors.lastname: Preiksaitis
authors.affiliation: Queen Elizabeth II Health Sciences Centre, Nephrology.
authors.forename: B
authors.initials: B
authors.lastname: Kiberd
authors.affiliation: University of Maryland.
authors.forename: E
authors.initials: E
authors.lastname: Schweitzer
authors.affiliation: University of Miami Miller School of Medicine.
authors.forename: S
authors.initials: S
authors.lastname: Ganz
authors.affiliation: Emory University School of Medicine, Pathology and Lab Medicine.
authors.forename: A
authors.initials: A
authors.lastname: Caliendo
authors.affiliation: Center for Donation and Transplant.
authors.forename: J P
authors.initials: JP
authors.lastname: Orlowski
authors.affiliation: Association of Organ Procurement Organizations.
authors.forename: B
authors.initials: B
authors.lastname: Wilson
authors.affiliation: Infectious Diseases, Massachusetts General Hospital.
authors.forename: C
authors.initials: C
authors.lastname: Kotton
authors.affiliation: Pediatric Infectious Diseases, Children's Hospital of Pittsburgh.
authors.forename: M
authors.initials: M
authors.lastname: Michaels
authors.affiliation: University of British Columbia.
authors.forename: S
authors.initials: S
authors.lastname: Kleinman
authors.affiliation: LABs Inc.
authors.forename: S
authors.initials: S
authors.lastname: Geier
authors.affiliation: Mount Sinai School of Medicine.
authors.forename: B
authors.initials: B
authors.lastname: Murphy
authors.affiliation: University of Pittsburgh School of Medicine.
authors.forename: M
authors.initials: M
authors.lastname: Green
authors.affiliation: University of Colorado Denver.
authors.forename: M
authors.initials: M
authors.lastname: Levi
authors.affiliation: University of Ottawa.
authors.forename: G
authors.initials: G
authors.lastname: Knoll
authors.affiliation: Johns Hopkins University.
authors.forename: Dorry L
authors.initials: DL
authors.lastname: Segev
authors.affiliation: American Association of Tissue Banks.
authors.forename: S
authors.initials: S
authors.lastname: Brubaker
authors.affiliation: Association of Organ Procurement Organizations (AOPO).
authors.forename: R
authors.initials: R
authors.lastname: Hasz
authors.affiliation: Cleveland Clinic Children's Hospital and AOPO.
authors.forename: D J
authors.initials: DJ
authors.lastname: Lebovitz
authors.affiliation: Mayo Clinic Arizona.
authors.forename: D
authors.initials: D
authors.lastname: Mulligan
authors.affiliation: Association of Organ Procurement Organizations (AOPO).
authors.forename: K
authors.initials: K
authors.lastname: O'Connor
authors.affiliation: University of Virginia Health System.
authors.forename: T
authors.initials: T
authors.lastname: Pruett
authors.affiliation: Gift of Hope Organ and Tissue Donor Network.
authors.forename: M
authors.initials: M
authors.lastname: Mozes
authors.affiliation: Infectious Diseases, University of Pennsylvania.
authors.forename: I
authors.initials: I
authors.lastname: Lee
authors.affiliation: New England Organ Bank.
authors.forename: F
authors.initials: F
authors.lastname: Delmonico
authors.affiliation: The Warren Alpert Medical School of Brown University and Rhode Island Hospital Joint consensus recommendations endorsed by: American Society of Transplantation (AST), Canadian Society of Transplantation (CST), American Society of Transplant Surgeons (ASTS). With additional sponsorship by: United Network for Organ Sharing (UNOS), American Association of Tissue Banks (AATB), Association of Organ Procurement Organizations (AOPO).
authors.forename: S
authors.initials: S
authors.lastname: Fischer
mesh_terms: D006801:Humans; D009696:Nucleic Acids / Q000032:analysis*; D014019:Tissue Donors
chemical_list: D009696:Nucleic Acids