Minimizing risk while maximizing opportunity: The infectious disease organ offer process survey

• Published in: Transplant infectious disease 2024-10, Vol.26 (5), p.e14342-n/a
• Main Authors: Prakash, Katya, Saharia, Kapil K., Karaba, Andrew, Law, Nancy, Albarillo, Fritzie S., Zangeneh, Tirdad T., Grossi, Paolo, Miller, Rachel, Slavin, Monica, Shoham, Shmuel, Ison, Michael, La Hoz, Ricardo M., Baddley, John W.
• Format: Article
• Language: English
• Subjects: Acceptability; Best practice; Communicable Diseases; Disease management; donor calls; Donor Selection - methods; Donor Selection - standards; Humans; infectious disease; Infectious diseases; Multidrug resistance; Optimization; organ evaluation; Organ Transplantation - adverse effects; Physicians; Polls & surveys; Risk reduction; Surveys; Surveys and Questionnaires; Tissue and Organ Procurement - methods; Tissue Donors; Transplant Recipients - statistics & numerical data; Transplants & implants
• ISSN: 1398-2273; 1399-3062; 1399-3062
• DOI: 10.1111/tid.14342

Background The purpose of this study was to understand how transplant infectious disease (TID) physicians assess a potential donor with known or suspected infection and describe posttransplant management. Methods We designed a survey of 10 organ offer scenarios and asked questions pertaining to organ acceptability for transplantation and management posttransplant. The survey was distributed to TID clinicians via transplant society listservs and email. Responses were recorded in REDCap, and descriptive statistics were employed. Results One hundred thirteen infectious disease physicians responded to the survey, of whom 85 completed all cases. Respondents were generally in agreement regarding organ acceptability, although some divergence was seen when evaluating lungs from donors with influenza, tuberculosis, or multidrug‐resistant Acinetobacter infection. Posttransplant management showed more variation. Areas of optimization were identified: (1) Further understanding of where risk‐mitigation strategies within the donor offer process may improve donor acceptability and therefore organ utilization; (2) importance of recipient considerations in assessing degree of infectious risk; and (3) gaps in evidenced‐based data regarding optimal posttransplant management of recipients. Conclusion Evaluation of donor offers by TID clinicians is a complex process. Although the survey does not itself serve to make recommendations regarding best practices, it highlights areas where generation of data to inform acceptance and management practices may allow for improved organ utilization and recipient management.