Seropositive abdominal and thoracic donor organs are largely underutilized

Area of Science:

• Transplantation Immunology
• Infectious Disease Epidemiology
• Organ Procurement

Background:

• Hepatitis B core protein (anti-HBc) and hepatitis C virus (anti-HCV) positivity in organ donors impacts organ utilization.
• Understanding trends in seropositivity and organ use is crucial for optimizing transplantation outcomes.

Purpose of the Study:

• To describe the epidemiology and utilization of organ donor referrals positive for anti-HBc and anti-HCV.
• To analyze trends in seropositivity and organ procurement/utilization rates over time.

Main Methods:

• Retrospective analysis of 3,134 deceased organ donor referrals between 1995 and 2006.
• Testing for anti-HBc and anti-HCV using commercial assays.
• Comparison of demographic data and organ utilization rates between seropositive and seronegative donors.

Main Results:

• Prevalence of anti-HCV(+) referrals increased significantly (3.4% to 8.1%), while anti-HBc(+) remained stable (3%-4%).
• Seropositive donors were older and more likely to be non-Caucasian.
• Thoracic and abdominal organs from seropositive donors showed significantly lower procurement and utilization rates.
• Liver utilization from anti-HBc(+) donors increased over time, but remained unchanged for anti-HCV(+) donors.

Conclusions:

• The proportion of anti-HCV(+) organ donors has risen, while anti-HBc(+) donors remain stable.
• Organs from both anti-HBc(+) and anti-HCV(+) donors, particularly thoracic and abdominal organs, are significantly underutilized.
• Strategies to improve the utilization of organs from seropositive donors are needed.