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Updated: May 30, 2026
Personalized Peptide Arrays for Detection of HLA Alloantibodies in Organ Transplantation
Published on: September 6, 2017
New technologies for infectious screening of organ donors
1Transplant Infectious Disease and Compromised Host Program, Infectious Disease Division and Transplant Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA. jfishman@partners.org
Abstract:
Viral, bacterial, parasitic, prion, and fungal infections, although uncommon, have been transmitted via organ and tissue allografts. Improved screening techniques for infectious diseases in organ donors have helped to reduce disease transmission. Reports of clusters of donor-derived infections illustrate the need to improve the screening of tissue and organ donors. Available microbiologic assays, including molecular tests, are generally designed for use as diagnostic tools in individuals believed to have a specific infection based on clinical or epidemiological criteria. These assays are frequently unsuitable in the screening of deceased organ donors. Nucleic acid testing may reduce the risk of disease transmission by detecting early-stage infection, including those from human immunodeficiency virus, hepatitis B virus, and hepatitis C virus in the "window" period before antibody seroconversion can be documented. Screening of organ donors for potential pathogens cannot completely exclude the risk of disease transmission. The process of donor screening must continue to evolve with advances in diagnostic technologies for infectious diseases.
Insights
Organ and tissue donation can transmit infections, but improved donor screening reduces risk. Advances in diagnostic technologies are crucial for evolving donor screening processes to prevent disease transmission.
Area of Science:
- Transplantation immunology
- Infectious disease transmission
- Microbiology
Background:
- Infections can be transmitted through organ and tissue allografts, posing a risk to recipients.
- While screening has improved, clusters of donor-derived infections highlight ongoing challenges.
- Current diagnostic assays are often unsuitable for deceased organ donor screening.
Purpose of the Study:
- To emphasize the critical need for enhanced screening of organ and tissue donors.
- To discuss the limitations of current diagnostic tools in donor screening.
- To highlight the importance of evolving screening protocols with technological advancements.
Main Methods:
- Review of existing literature on infectious disease transmission via allografts.
- Analysis of current organ and tissue donor screening practices.
- Evaluation of the utility of molecular diagnostic assays, such as nucleic acid testing (NAT).
Main Results:
- Nucleic acid testing can detect early-stage infections, including human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV), during the window period.
- Despite improvements, complete exclusion of disease transmission risk through donor screening remains challenging.
- Clusters of infections underscore the necessity for more robust and adaptive screening strategies.
Conclusions:
- Continuous evolution of donor screening processes is essential.
- Advancements in diagnostic technologies are vital for minimizing infectious disease transmission in transplantation.
- Enhanced screening protocols are necessary to ensure the safety of organ and tissue allografts.
