Donor-derived tuberculosis: Don’t forget to screen potential organ donors for TB!

Reviewed by Erica Stohs, MD, MPH, University of Nebraska

The US Organ Procurement and Transplant Network’s (OPTN) ad hoc Disease Transmission Advisory Committee reviewed cases of potential donor-derived TB reported to the OPTN between 2008-2018. Nine of 51 deceased donors were determined to have transmitted proven/probable TB to at least one recipient and 18 of 51 with possible transmission to recipients.

From the 9 donors with proven/possible transmissions, 11 recipients (6 lung, 2 kidney, 2 liver and 1 combined liver-kidney) developed TB, while 9 received therapeutic intervention without disease transmission; the remaining recipients were either non-evaluable or excluded. Eight of these 9 donors were identified due to recipient development of TB. Of 18 donors with possible transmissions, 18 recipients developed TB, 4 received therapeutic intervention without disease transmission; 49 recipients were excluded or non-evaluable. Finally in 24 donors with TB findings, 50 recipients received therapeutic intervention without disease transmission.

The lack of highly sensitive TB diagnostics limit donor screening for TB. Authors recommend screening potential donors for TB risk factors. AFB smear and culture of respiratory samples obtained by bronchoscopy in donors with TB risk factors and/or symptoms may allow for intervention before development of recipient disease.

Malinis M, et al. “Donor-derived tuberculosis among solid organ transplant recipients in the United States – 2008-2018.” Transplant Infectious Disease 2022;24:e13800. https://doi10.1111/tid.13800.

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