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Improving syphilis screening in deceased organ donors
Nicole Theodoropoulos1, Andrés Jaramillo, Sudhir Penugonda
11 Division of Infectious Disease, The Ohio State University, Columbus, OH. 2 Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University, Chicago, IL. 3 Gift of Hope Organ and Tissue Donor Network, Itasca, IL. 4 Division of Infectious Disease, Northwestern University Feinberg School of Medicine, Chicago, IL. 5 Division of Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, IL.
Current syphilis screening for organ donors using RPR tests results in many false positives. Alternative or confirmatory testing may improve accuracy and organ recovery rates.
Area of Science:
- Infectious Disease
- Transplantation Immunology
- Clinical Diagnostics
Background:
- U.S. policy mandates syphilis screening for all deceased organ donors.
- Limited data exists on syphilis test performance in deceased organ donors.
- Rapid Plasma Reagin (RPR) is the current screening method.
Purpose of the Study:
- To evaluate the performance of syphilis tests in deceased organ donors.
- To assess the rate of false-positive RPR results in this population.
- To compare RPR with treponemal-specific tests for syphilis detection.
Main Methods:
- Retrospective analysis of serum samples from deceased organ donors (2000-2012).
- Tested RPR-positive and RPR-negative donors with alternate RPR and four treponemal-specific tests.
- Treponemal tests included: FTA-ABS, MHA-TP, CLIA, and TP-PA.
Main Results:
- 0.9% of donors screened were RPR-positive.
- 40.6% of RPR-positive donors had false-positive results confirmed by TP-PA.
- Chemiluminescence immunoassay (CLIA) showed 100% sensitivity and concordance with TP-PA.
Conclusions:
- RPR screening for deceased organ donors generates a significant number of false positives.
- Alternative or routine confirmatory syphilis testing could reduce false positives.
- Improved testing accuracy may increase organ recovery for transplantation.
