title: Outcome of Transplantation Using Organs From Donors Infected or Colonized With Carbapenem-Resistant Gram-Negative Bacteria.
abstract: Donor-derived infections due to multidrug-resistant bacteria are a growing problem in solid organ transplantation, and optimal management options are not clear. In a 2-year period, 30/214 (14%) recipients received an organ from 18/170 (10.5%) deceased donors with infection or colonization caused by a carbapenem-resistant gram-negative bacteria that was unknown at the time of transplantation. Among them, 14/30 recipients (47%) received a transplant from a donor with bacteremia or with infection/colonization of the transplanted organ and were considered at high risk of donor-derived infection transmission. The remaining 16/30 (53%) recipients received an organ from a nonbacteremic donor with colonization of a nontransplanted organ and were considered at low risk of infection transmission. Proven transmission occurred in 4 of the 14 high-risk recipients because donor infection was either not recognized, underestimated, or not communicated. These recipients received late, short or inappropriate posttransplant antibiotic therapy. Transmission did not occur in high-risk recipients who received appropriate and prompt antibiotic therapy for at least 7 days. The safe use of organs from donors with multidrug-resistant bacteria requires intra- and inter-institutional communication to allow appropriate management and prompt treatment of recipients in order to avoid transmission of infection.
authors.affiliation: Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mularoni
authors.affiliation: Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bertani
authors.affiliation: Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Vizzini
authors.affiliation: Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Gona
authors.affiliation: Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Campanella
authors.affiliation: Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Spada
authors.affiliation: Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Gruttadauria
authors.affiliation: Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Vitulo
authors.affiliation: Department of Laboratory Medicine and Advanced Biotechnologies, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Conaldi
authors.affiliation: Department of Diagnostic and Therapeutic Services, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Luca
authors.affiliation: Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS - ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Gridelli
authors.affiliation: Department of Infectious and Tropical Diseases, University of Insubria, Varese, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Grossi
mesh_terms: D000328:Adult; D000368:Aged; D015780:Carbapenems; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D012189:Retrospective Studies; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D015780:Carbapenems
keywords: Clinical research/practice; bacterial; donors and donation: donor-derived infections; infection and infectious agents; infectious disease; organ procurement and allocation; organ transplantation in general