THE ROLE OF TESTING IN DETERMINING SUITABILITY OF DONORS AND TISSUES

Viral, bacterial, prion, and fungal infections have been transmitted via tissue allografts such as bone, tendon, skin, cornea, dura mater, pericardium, blood vessels, and heart valves. Over the past several years, improvements in tissue donor suitability requirements and donor blood testing have greatly reduced this risk. For example, improved tissue banking standards and practices currently in place would have prevented previously reported cases of disease transmission that resulted from the use of hemodiluted blood samples for infectious disease testing (there have been human immunodeficiency virus [HIV] transmissions by organs because of hemodilution), accepting donors with behavioral risks for HIV infection, and using early generation, less sensitive tests for HIV and hepatitis C virus (HCV) antibodies. In this chapter, donor blood testing, its rationale, the challenges associated with testing in general, bacterial and fungal testing of tissues and new technologies for viral and bacterial testing are discussed.