Child Organ Offer Process (cOOPS): Understanding Infectious Risk Assessment and Mitigation Strategies.

Area of Science:

• Pediatric Infectious Diseases
• Solid Organ Transplantation
• Infection Control

Background:

• Pediatric Infectious Disease (PID) clinicians evaluate infection risks for donor organ offers in solid organ transplantation.
• Current practice patterns for real-life scenarios are not well-described.

Purpose of the Study:

• To describe the practice patterns of PID clinicians regarding donor organ acceptance and post-transplantation interventions.
• To identify areas of consensus and variability in decision-making for pediatric organ offers.

Main Methods:

• A survey was distributed to PID clinicians via 3 PID-specific listservs.
• 12 fictitious pediatric case scenarios were used to assess organ acceptance and post-transplantation interventions.
• Descriptive statistics were employed to analyze the survey data.

Main Results:

• High agreement (>80%) was observed for accepting organs with syphilis, SARS-CoV-2, MRSA, E. coli, TB (liver), and rhino/enterovirus.
• Lower agreement was found for organs with risks of coccidioidomycosis, Chagas disease, multidrug-resistant Acinetobacter baumannii, and influenza.
• Variability existed in post-transplant monitoring, antimicrobial administration, and donor testing for specific infections like SARS-CoV-2, MRSA, and Chagas disease.

Conclusions:

• While consensus exists for many pediatric organ offer scenarios, enhanced education on current recommendations can improve decision-making.
• Variability in management highlights opportunities for education and research to optimize strategies against donor-derived infections in pediatric recipients.