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Screening algorithms for HBV, HCV, HIV and syphilis in an anatomical donation program
Brecht Valcke1, Koen Vercauteren2, Elizaveta Padalko3
1Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
Summary
Early postmortem blood sampling is crucial for anatomical donors to minimize hemolysis, which can affect infectious disease test results and donor acceptance rates. Optimizing screening algorithms improves donor allocation accuracy.
Area of Science:
- Anatomical donation and infectious disease screening
- Postmortem diagnostics and sample integrity
Background:
- Anatomical donors face risks from bloodborne pathogens.
- Existing screening algorithms for hepatitis B and C virus, human immunodeficiency virus, and Treponema pallidum require evaluation.
Purpose of the Study:
- To assess screening algorithms for bloodborne pathogens in anatomical donors.
- To determine the impact of postmortem interval on hemolysis.
- To evaluate how hemolysis affects test results and donor discard rates.
Main Methods:
- Collected demographic data, postmortem blood sampling times, hemolysis presence, serological test results, and donor allocation data from 2011-2018.
- Analyzed the relationship between postmortem time, hemolysis, and infectious disease screening outcomes.
- Evaluated donor discard rates based on sample hemolysis and test results.
Main Results:
- Nine donors (1.68%) showed active infections. Hemolysis increased significantly with sampling >24 hours postmortem (p < 0.001).
- Hemolytic samples led to more indeterminate/reactive human immunodeficiency virus results (p < 0.001) and technical difficulties for human immunodeficiency virus and T. pallidum screening (p = 0.042, p = 0.003).
- Donors with hemolytic samples had higher discard rates (46.88%) versus non-hemolytic (6.32%) (p < 0.001).
Conclusions:
- Current donor screening algorithms result in inconsistent allocation.
- Simplifying algorithms and adding nucleic acid testing can improve reliability.
- Early postmortem sampling is vital to mitigate hemolysis impact on test results and donor allocation.
