Infectious Risk Donor Status in Uncontrolled Donation After Circulatory Death and Liver Transplantation

Few data are so far available concerning the infectious risk donor profile in uncontrolled donation after circulatory death (uDCDs), despite the high incidence of infectious complications observed in out-of-hospital cardiac arrest patients.

We assessed the donor risk profile in utilized uDCD donors consecutively assessed from 2018 to 2024, focusing on the outcome of liver transplant recipients.

Fifty-two consecutive utilized uDCDs were included. In 16 uDCDs, blood cultures were positive. In all these cases, Gram-positive bacteria were observed, mainly cocci (14/16, 88%). These microorganisms were considered contaminants. None of these microorganisms were isolated in recipients. No donor-related infection was detected in the 24 liver transplant recipients.

According to our results, uDCDs show a low risk of infection transmission to the recipients. Nevertheless, a careful and systematic approach to donor evaluation should be pursued and implemented, considering the restricted time frame for assessment and the urgent procedures performed, considering the characteristics of uDCD (comprising the performance of an urgent procedure). Transplant coordinators should promptly report culture positivity in one of the collected samples, thus allowing the timely initiation of antibiotic therapy in the recipients. In uDCD donors, some information on infectious risk may be lacking, considering the limited time and that a urine culture may not be feasible since these donors may be anuric.