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The fate of cadaver renal allografts contaminated before transplantation
Abstract:
Through the routine use of cultures from saline slush transport solution and the initial and final organ perfusates, 14 of 81 cadaver allografts (17.3%) were found to have been contaminated before transplantation. Gram negative organisms, cultured from 5 of the 14 contaminated allografts, resulted in the recipient's death on the first encounter with this problem and the loss of two other allografts. Early antibiotic therapy begun even without evidence of overt infection appeared to prevent any further deaths or graft loss in those whose allografts were contaminated and yielded an overall survival comparable to that of uncontaminated allografts. Without such an approach to the study of perfused cadaver allografts and the management of them when found to be contaminated, this type of infection may go undetected and contribute to allograft and patient loss.
Insights
Routine cultures detected contamination in 17.3% of cadaver allografts. Early antibiotic therapy for contaminated organ transplants prevented graft loss and deaths, ensuring comparable survival rates.
Area of Science:
- Transplantation immunology
- Microbiology
- Infectious disease
Background:
- Cadaver allografts are crucial for transplantation.
- Assessing microbial contamination in donor organs is vital for patient safety.
Observation:
- Routine cultures of saline slush transport solution and organ perfusates identified contamination in 17.3% of allografts.
- Gram-negative organisms were identified in 5 of the contaminated allografts.
Findings:
- Contamination with Gram-negative organisms led to recipient death in one case and loss of two allografts.
- Proactive antibiotic therapy, even without overt infection signs, prevented further deaths and graft loss in contaminated cases.
- This management strategy resulted in survival rates comparable to uncontaminated allografts.
Implications:
- Undetected infections in transplanted organs can lead to significant patient and allograft loss.
- Implementing routine microbiological surveillance and early intervention protocols is essential for improving allograft survival.
- Proactive management of contaminated allografts can mitigate severe outcomes and enhance transplantation success.