Nucleic acid testing (NAT) of organ donors: is the 'best' test the right test? A consensus conference report.
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.
Humar
A
A
Transplant Infectious Diseases, University of Alberta.
Morris
M
M
Infectious Diseases, University of Miami Miller School of Medicine.
Blumberg
E
E
Infectious Diseases, University of Pennsylvania.
Freeman
R
R
Tufts Medical Center.
Preiksaitis
J
J
Transplant Infectious Diseases, University of Alberta.
Kiberd
B
B
Queen Elizabeth II Health Sciences Centre, Nephrology.
Schweitzer
E
E
University of Maryland.
Ganz
S
S
University of Miami Miller School of Medicine.
Caliendo
A
A
Emory University School of Medicine, Pathology and Lab Medicine.
Orlowski
J P
JP
Center for Donation and Transplant.
Wilson
B
B
Association of Organ Procurement Organizations.
Kotton
C
C
Infectious Diseases, Massachusetts General Hospital.
Michaels
M
M
Pediatric Infectious Diseases, Children's Hospital of Pittsburgh.
Kleinman
S
S
University of British Columbia.
Geier
S
S
LABs Inc.
Murphy
B
B
Mount Sinai School of Medicine.
Green
M
M
University of Pittsburgh School of Medicine.
Levi
M
M
University of Colorado Denver.
Knoll
G
G
University of Ottawa.
Segev
Dorry L
DL
Johns Hopkins University.
Brubaker
S
S
American Association of Tissue Banks.
Hasz
R
R
Association of Organ Procurement Organizations (AOPO).
Lebovitz
D J
DJ
Cleveland Clinic Children's Hospital and AOPO.
Mulligan
D
D
Mayo Clinic Arizona.
O'Connor
K
K
Association of Organ Procurement Organizations (AOPO).
Pruett
T
T
University of Virginia Health System.
Mozes
M
M
Gift of Hope Organ and Tissue Donor Network.
Lee
I
I
Infectious Diseases, University of Pennsylvania.
Delmonico
F
F
New England Organ Bank.
Fischer
S
S
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).
D006801:Humans; D009696:Nucleic Acids / Q000032:analysis*; D014019:Tissue Donors
D009696:Nucleic Acids