Deceased organ donor screening for human immunodeficiency virus, hepatitis B virus and hepatitis C virus: Discordant serology and nucleic acid testing results

作者：Theodoropoulos Nicole^*; Nowicki Marek J; Chinchilla Reyes Claudia; Dionne Sara; Jaramillo Andres; Mone Tom; Hasz Richard; Jendrisak Martin D; Ladner Daniela P; Ison Michael G

来源：Transplant Infectious Disease, 2018, 20(1): e12821.

DOI：10.1111/tid.12821

• donor screening
• hepatitis B
• hepatitis C
• HIV
• nucleic acid testing
• serology

BackgroundBefore the 2014 policy change pertaining to infectious disease screening, many organ procurement organizations (OPOs) were supplementing serologic screening of deceased organ donors with nucleic acid testing (NAT) for human immunodeficiency virus (HIV-1), hepatitis B virus (HBV), and hepatitis C virus (HCV). The number of seronegative, NAT-positive donors has not been directly measured.
MethodsHIV, HBV, and HCV screening results of 11229 donor referrals evaluated from 2010 to 2013 were obtained from 3 OPO-affiliated laboratories, capturing 35% of all donors in the United States. Laboratories used either polymerase chain reaction assay or transcription-mediated amplification assay to test 9643 deceased donors by NAT.
ResultsThe NAT results were positive in 21 (0.2%), 1 (0.02%), and 11 (0.1%) donors who were seronegative for HIV, HBV, and HCV, respectively. All discordant HIV-1 results were from one laboratory using a polymrease chain reaction assay. Thirteen of the reactive HIV NAT results in seronegative referrals were repeated and were non-reproducibly positive (NRP). Ten (0.1%), 452 (7.8%), and 197 (2.2%) of HIV-, HBV-, and HCV-seropositive donors, respectively, were negative by NAT.
ConclusionsThis study highlights the importance of robust quality assurance to minimize NRP NAT results. NAT may allow for increased utilization of organs from HBV- and HCV-seropositive, NAT-negative donors.

• 出版日期2018-2