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The species, distribution, resistance of donor-derived pathogens and their impact on solid organ transplant

Yan-Man Zhou1, Xian-Quan Cui2, Peng Zhao2

  • 1Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.

Frontiers in Immunology
|March 23, 2026
PubMed
Abstract

Insights

Donor-derived infections are common in transplant recipients. Metagenomic next-generation sequencing (mNGS) of donor preservation fluid can detect pathogens, improving transplant outcomes.

Area of Science:

  • Transplant Infectious Diseases
  • Microbiology
  • Genomics

Background:

  • Donor-derived infections (DDIs) are a significant threat to organ transplant recipients.
  • Understanding donor-derived pathogens (DDPs) is crucial for preventing DDIs.

Purpose of the Study:

  • To investigate the prevalence and characteristics of DDPs in deceased donors.
  • To compare the efficacy of conventional culture and mNGS for DDP detection.
  • To determine the incidence and impact of DDIs on transplant recipients.

Main Methods:

  • Retrospective cohort study of 302 deceased donors and 639 transplant recipients (464 kidney, 175 liver).
  • Detection of DDPs in preservation fluid (PF) using conventional culture and mNGS.
  • Analysis of DDI incidence and patient outcomes.

Main Results:

  • 89.4% of donors had positive cultures, with prevalent multidrug-resistant organisms (MDROs).
  • mNGS showed superior sensitivity and faster turnaround time than conventional culture for pathogen detection in PF.
  • DDIs occurred in 16.6% of kidney and 19.4% of liver recipients, associated with adverse outcomes.

Conclusions:

  • MDROs are common in deceased donors, with PF contamination frequently originating from the donor.
  • Integrating mNGS into donor screening can facilitate timely antimicrobial interventions.
  • Improved DDP detection via mNGS may enhance transplant outcomes.
Keywords:
donor-derived infectionmetagenomic next-generation sequencingmultidrug-resistant organismpreservation fluidsolid organ transplantation

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