Impact of deceased donor multidrug-resistant bacterial organisms on organ utilization

Area of Science:

• Transplantation
• Infectious Diseases
• Organ Donation

Background:

• The impact of multidrug-resistant organisms (MDROs) in deceased donors on organ utilization is not well understood.
• Assessing this association is crucial for optimizing organ donor pool and transplant outcomes.

Purpose of the Study:

• To evaluate the association between donor MDROs and organ utilization metrics.
• To specifically investigate the effect of multidrug-resistant Gram-negative (MDR-GN) organisms on organ transplantation.

Main Methods:

• Retrospective cohort study at 4 transplant centers (2015-2016).
• Included deceased donors with at least one organ donation.
• Analyzed donor cultures for MDROs and used multivariable regression to assess organ utilization (number of organs transplanted, match run acceptance).

Main Results:

• No significant association between overall donor MDROs and organ utilization.
• Donor MDR-GNs (2% of donors) were associated with a significant reduction in organs transplanted per donor (IRR 0.43).
• Organs from MDR-GN positive donors were accepted significantly further down the match list (relative count 5.08).

Conclusions:

• While infrequent, donor MDR-GNs significantly reduce organ utilization.
• The increasing prevalence of MDR-GNs poses a potential threat to the donor pool.
• Further research and strategies to mitigate the impact of MDR-GNs in organ donation are warranted.