How to detect bacterial contamination prior to transplantation

The mortality of kidney transplantation generally amounts to 10% due to infections and GIT complications. Once grafting a Staphylococcus aureus and Streptococcus contaminated kidney the recipient had to undergo emergency surgery four times. Hence it has become our routine to sample the perfusate on blood culture media. Among 145 donor nephrectomies the microbiologic examination of the kidney perfusate in which the graft is stored and transported turned out to be positive in 28%. Four out of five germs isolated after incubation on blood culture media were of the non-pathogenic type seen in the normal flora of the skin. Making use of the CIT (24-30 hours) we cultured the perfusate on blood media. Since the temporary results of the microbiological examination are obtained within 12 hours we can initiate the first choice antibiotic therapy already at the time of transplantation. Though there was proof of highly pathogenic bacteria clinical infection occurred in none of our patients among a total of 114 grafts. The outstanding clinical importance of this diagnostic tool arises from the time sparing information of any contamination and the early hint at the first choice of antibiotics. The distinct application of antibiotics according to the result of the perfusate culture on blood culture media is superior to a general antibiotic cover.