Tissue donation and virus safety: more nucleic acid amplification testing is needed

Area of Science:

• Virology
• Transplantation Immunology
• Public Health

Background:

• Serologic testing is standard for blood-borne viruses in tissue/organ transplantation.
• Mandatory NAT for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) is not yet widespread in many countries.
• Viral transmission via transplanted tissues poses a significant recipient health risk.

Purpose of the Study:

• To evaluate the significance of NAT for HIV, HBV, and HCV detection in tissue donors.
• To compare NAT's efficacy with existing serologic methods and blood banking practices.
• To assess viral transmission risks associated with different tissue types (musculoskeletal, cardiovascular, cornea).

Main Methods:

• Literature review on viral transmission events, tissue-specific factors, and inactivation procedures.
• Evaluation of NAT for detecting HIV, HBV, and HCV in various tissue donors.
• Comparison of findings with blood banking organization experiences.

Main Results:

• Musculoskeletal tissues present a high risk of HIV, HBV, and HCV transmission due to high blood content and donor-recipient ratios.
• Cardiovascular tissues, despite low transmission risk with serologic screening, require NAT due to impossible inactivation and high donor-recipient ratios.
• Corneal allografts have the lowest risk, but NAT for HCV is recommended.

Conclusions:

• NAT screening for HIV, HBV, and HCV is essential for high-risk tissues like musculoskeletal and cardiovascular.
• NAT for HCV in corneal donors is advised.
• Negative NAT results may obviate the need for quarantine storage; collaboration with blood banks for virological testing is beneficial.