Donor derived infections

Despite the development of new policies and the use of highly sensitive assays, reports of the transmission of infection to organ transplantation recipients remain uncommon but occur with sufficient frequency to suggest that current approaches to screening of donors are inadequate. The role of geographically restricted microorganisms has also increased as a consequence of travel and migration of populations. The commercialization of transplantation in some regions may also minimize the incentive to test and exclude potentially infected donors. Recent clusters of organ-associated viral transmissions illustrate the vulnerability of immunosuppressed recipients to infections due to organisms of limited native virulence for normal individuals. Many potential exposures are too common or too nonspecific to allow appropriate decision-making regarding the risk of transmission. Furthermore, in some clusters of documented transmissions (e.g. due to lymphocytic choriomeningitis, LCMV), no clear exposure or evidence of donor infection could be demonstrated even in retrospective investigation.