title: Donor-derived transmission events in 2013: a report of the Organ Procurement Transplant Network Ad Hoc Disease Transmission Advisory Committee.
abstract: BACKGROUND
  The Organ Procurement Transplant Network Disease Transmission Advisory Committee (DTAC), a multidisciplinary committee, evaluates potential donor-derived transmission events (PDDTE), including infections and malignancies, to assess for donor transmitted events.
  
  
  METHODS
  Reports of unexpected PDDTE to Organ Procurement Transplant Network in 2013 were fully reviewed by DTAC. A standardized algorithm was used to assess each PDDTE from a given donor and to classify each individual recipient from that donor.
  
  
  RESULTS
  Of 443 total PDDTE submitted, 159 were triaged and not sent out to the full DTAC. Of 284 fully evaluated reports, 32 (11.3%) resulted in a proven/probable (P/P) transmission of infection, malignancy or other conditions to 42 recipients. Of 204 infection events, 24 were classified as P/P affecting 30 recipients, with four deaths. Bacteria were the most frequently reported type of infection, accounting for 99 reports but only 12 recipients from 11 donors experienced P/P transmission. There were 65 donors reported with potential malignancy events and 5 were classified as P/P transmissions with 8 affected recipients and 2 deaths. Additionally, there were 16 noninfection, nonmalignancy reports resulting in 3 P/P transmissions to 4 recipients and 1 death.
  
  
  CONCLUSIONS
  There was a 43% increase in the number of PDDTE reported and reviewed in 2013 over 2012. However, the percent with P/P transmission remains low, affecting recipients from 32 donors especially when compared with the more than 14,000 donors recovered annually in the United States. The continued use of the new standard algorithm and triaging process will enhance the reproducibility of DTAC assessments and allow more robust analysis of our aggregate DTAC experience.
authors.affiliation: 1 Division of Pediatric Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA. 2 United Network for Organ Sharing, Richmond, VA. 3 Division of Transplant Infectious Disease, Duke University Medical Center, Durham, NC. 4 Division of Anatomic Pathology, University of Alabama, Birmingham, AL. 5 Division of Gastroenterology, University of Colorado, Aurora, CO. 6 Department of Transplant Surgery, Albany Medical College, Albany, NY. 7 Lifesharing, San Diego, CA. 8 Division of Infectious Disease, Methodist Dallas Medical Center, Dallas, TX. 9 Transplant Clinical Operations, Indiana University Hospital, Indianapolis, IN. 10 Center for Global Health, National Cancer Institute, Rockville, MD. 11 Joint Pathology Center, Silver Spring, MD. 12 Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA. 13 Mount Sinai Medical Center, New York, NY. 14 Division of Cardiac Transplant, Seattle Children's Hospital, Seattle, WA. 15 Cleveland Clinic, Cleveland, OH. 16 Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY. 17 Division of Internal Medicine, University of Miami Hospital, Miami, FL. 18 Division of Transplant Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA. 19 Division of Nephrology, Beth Israel Deaconess Medical Center, Boston, MA. 20 Division of Transplantation, University of Minnesota Medical Center, Minneapolis, MN. 21 Division of Infectious Diseases, University of Virginia Health System, Charlottesville, VA. 22 Division of Infectious Diseases, University of Michigan Medical Center, Ann Arbor, MI.
authors.forename: Michael
authors.initials: M
authors.lastname: Green
authors.forename: Shandie
authors.initials: S
authors.lastname: Covington
authors.forename: Sarah
authors.initials: S
authors.lastname: Taranto
authors.forename: Cameron
authors.initials: C
authors.lastname: Wolfe
authors.forename: Walter
authors.initials: W
authors.lastname: Bell
authors.forename: Scott W
authors.initials: SW
authors.lastname: Biggins
authors.forename: David
authors.initials: D
authors.lastname: Conti
authors.forename: G David
authors.initials: GD
authors.lastname: DeStefano
authors.forename: Edward
authors.initials: E
authors.lastname: Dominguez
authors.forename: Donna
authors.initials: D
authors.lastname: Ennis
authors.forename: Thomas
authors.initials: T
authors.lastname: Gross
authors.forename: Mary
authors.initials: M
authors.lastname: Klassen-Fischer
authors.forename: Camille
authors.initials: C
authors.lastname: Kotton
authors.forename: Dianne
authors.initials: D
authors.lastname: LaPointe-Rudow
authors.forename: Yuk
authors.initials: Y
authors.lastname: Law
authors.forename: Kristen
authors.initials: K
authors.lastname: Ludrosky
authors.forename: Marilyn
authors.initials: M
authors.lastname: Menegus
authors.forename: Michele I
authors.initials: MI
authors.lastname: Morris
authors.forename: Michael A
authors.initials: MA
authors.lastname: Nalesnik
authors.forename: Martha
authors.initials: M
authors.lastname: Pavlakis
authors.forename: Timothy
authors.initials: T
authors.lastname: Pruett
authors.forename: Costi
authors.initials: C
authors.lastname: Sifri
authors.forename: Daniel
authors.initials: D
authors.lastname: Kaul
mesh_terms: D026683:Advisory Committees; D000465:Algorithms; D003661:Decision Support Techniques; D018562:Disease Transmission, Infectious; D046148:Donor Selection; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology; D016377:Organ Transplantation / Q000009:adverse effects*; D061214:Patient Safety; D011183:Postoperative Complications / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology