Organ Donation Flashcards
Which organs can be donated from a patient who died and COVID was a contributing factor?
Which organs can be donated from a patient who is SARS-CoV-2 positive but with no COVID diagnosis at time of death?
What is the prophylaxis/follow up in the recipient?
None - donations not accepted
Donations of non-lung organs accepted (low risk). No prophylaxis, but recipients should be tested weekly for 14 days
What testing is done pre organ transplant for HHV-8? And when was this initiated in the UK? Which organ transplant is most often affected?
Serology is performed pre transplant, but results not available Pre transplant
Started in 2023
Kidney transplant
What follow up would you do for an HHV-8 negative patient transplanted with an HHV-8 positive organ?
PCR monthly for 3 months
PCR quarterly for next 9 months
Final serology at 18 months
Seroconversion should be detected within 3 months and disease usually occurs within 18 months
Which organs can be donated from a patient who
a) Died due to influenza infection
b) Had influenza but did not die of flu
What would be the prophylaxis?
a) Lung (and bowel*) contraindicated. All other organs can be used
b) Lung can be used after thorough assessment - prophylaxis required. All other organs can be used
Prophylaxis can be used, but if so then treatment doses should be used. Can screen by PCR between days 2-10 post transplant
*Note SaBTO says can’t use bowel, flu specific guidelines say you can…
When a patient with HBV/HDV has a liver transplant what can they receive (HBV status)?
Only HBV negative livers to avoid superinfection of the transplanted liver
Prophylaxis for HBV/HDV infected patients post liver transplant
HBIG and NAs should be continued indefinitely
How long should gamete donation be deferred after leaving an Ebola risk area?
2 years for males, 6 months for females
When can organs from deceased donors with HIV be used?
In exceptional circumstances for HIV - recipients
Or in HIV + recipients (who have well controlled HIV) as long as donor is:
CD4 >200
VL <50 for 6 months prior to death
No drug resistance or failure
Genotype info available if possible
When can deceased donor testing be performed?
From 7 days prior to 24 h after death
What are mandatory tests for organ donation?
What are recommended?
Mandatory - HIV (4th gen), HBsAg, anti-HBc, HCV Ab
Recommended:
CMV IgG
EBV IgG
HEV RNA
HHV-8 Ab
Syphilis Ab
Toxo IgG
HTLV1/2 Ab (if from high risk area)
What are mandatory tests for tissue donation?
What are recommended?
Mandatory:
HIV (4th gen)
HBsAg
anti-HBc
HCV Ab
Syphilis Ab
HTLV-1/2 Ab (if from high risk)
Recommended:
HEV RNA
What are mandatory tests for gamete donation?
What are recommended?
Mandatory:
HIV (4th gen)
HBsAg
anti-HBc
HCV Ab
Syphilis Ab
HTLV-1/2 Ab (if from high risk)
Chlamydia
Gonorrhoea
Recommended:
CMV IgG
What are mandatory tests for cell donation?
What are recommended?
Mandatory:
HIV (4th gen)
HBsAg
anti-HBc
HCV Ab
Syphilis Ab
HTLV-1/2 Ab (if from high risk)
Recommended:
HEV RNA
CMV IgG
EBV IgG
Toxo IgM and IgG
If organ donor is under 18 m then what additional testing is required?
Full screening of both mother and infant
What is haemodilution in respect of transplant donor testing?
What is the cut-off level of haemodilution acceptable for testing?
How can this be avoided/risk minimised?
Dilution of Ag/Ab due to transfusions/fluids, risk of false negatives
If haemodilution >50% then pre transfusions samples should be used
NAAT testing can be considered
