title: Use of organs from donors with bloodstream infection, pneumonia, and influenza: Results of a survey of infectious diseases practitioners.
abstract: BACKGROUND
  Potential organ donors may be admitted with an infection to an intensive care unit, or contract a nosocomial infection during their stay, increasing the risk of potential transmission to the recipient. Because of a lack of practice guidelines and large-scale data on this topic, we undertook a survey to assess the willingness of transplant infectious diseases (ID) physicians to accept such organs.
  
  
  METHODS
  We performed a 10-question survey of ID providers from the American Society of Transplantation Infectious Disease Community of Practice to determine the scope of practice regarding acceptance of organs from donors with bloodstream infection, pneumonia, and influenza prior to organ procurement, as well as management of such infections following transplantation.
  
  
  RESULTS
  Among 60 respondents to our survey, a majority indicated that organs would be accepted from donors bacteremic with streptococci (76%) or Enterobacteriaceae (73%) without evidence of drug resistance. Acceptance rates varied based on infecting organism, type of organ, and center size. Ten percent of respondents would accept an organ from a donor bacteremic with a carbapenem-resistant organism. Over 90% of respondents would accept an organ other than a lung from a donor with influenza on treatment, compared with 52% that would accept a lung in the same setting.
  
  
  CONCLUSIONS
  This study is the first to our knowledge to survey transplant ID providers regarding acceptance of organs based on specific infections in the donor. These decisions are often based on limited published data and experience. Better characterization of the outcomes from donors with specific types of infection could lead to liberalization of organ acceptance practices across centers.
authors.affiliation: Division of Infectious Diseases, University of California, San Diego, La Jolla, CA, USA.|Division of Infectious Diseases, San Diego Veterans Affairs Medical Center, San Diego, CA, USA.
authors.forename: Sanjay R
authors.initials: SR
authors.lastname: Mehta
authors.affiliation: Division of Infectious Diseases, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Cathy
authors.initials: C
authors.lastname: Logan
authors.affiliation: Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Camille N
authors.initials: CN
authors.lastname: Kotton
authors.affiliation: Division of Infectious Diseases, University of Toronto, Toronto, ON, Canada.
authors.forename: Deepali
authors.initials: D
authors.lastname: Kumar
authors.affiliation: Division of Infectious Diseases, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Saima
authors.initials: S
authors.lastname: Aslam
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology / Q000635:transmission*; D001419:Bacteria / Q000302:isolation & purification; D058387:Candidemia / Q000382:microbiology / Q000635:transmission*; D015780:Carbapenems / Q000494:pharmacology / Q000627:therapeutic use; D000066491:Clinical Decision-Making; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology / Q000635:transmission*; D046148:Donor Selection; D024881:Drug Resistance, Bacterial; D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy / Q000382:microbiology / Q000635:transmission*; D011014:Pneumonia / Q000188:drug therapy / Q000382:microbiology*; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires; D014019:Tissue Donors; D019737:Transplants / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems
keywords: organ donor infection; solid organ transplant; survey