Screening Live Kidney Donors for Endemic Infections
Screening Live Kidney Donors for Endemic Infections
In February 2013, the Organ Procurement and Transplantation Network mandated that transplant centers perform screening of living kidney donors prior to transplantation for Strongyloides, Trypanosoma cruzi and West Nile virus (WNV) infection if the donor is from an endemic area. However, specific guidelines for screening were not provided, such as the optimal testing modalities, timing of screening prior to donation and the appropriate selection of donors. In this regard, the American Society of Transplantation Infectious Diseases Community of Practice, together with disease-specific experts, has developed this viewpoint document to provide guidance for the testing of live donors for Strongyloides, T. cruzi and WNV infection, specifically identifying at-risk populations and testing algorithms, including advantages, limitations and interpretation of results.
Strongyloides, Trypanosoma cruzi and West Nile virus (WNV) are important pathogens that have been transmitted via deceased organ donors. Given the potential for transmission to result from living donation, the Organ Procurement and Transplantation Network (OPTN) mandated, effective February 2013, that transplant centers must test for evidence of infection with Strongyloides, T. cruzi and WNV if the potential live donor is from an endemic area. However, the policy does not provide specific guidance regarding implementation, including appropriate selection of donors for testing, optimal testing modalities and timing. Therefore, the American Society of Transplantation Infectious Diseases Community of Practice, in conjunction with disease-specific experts, has developed this viewpoint to provide guidance related to testing of live donors for these infections with a focus on the identification of at-risk populations, advantages and limitations of specific testing algorithms, and interpretation of results.
Abstract and Introduction
Abstract
In February 2013, the Organ Procurement and Transplantation Network mandated that transplant centers perform screening of living kidney donors prior to transplantation for Strongyloides, Trypanosoma cruzi and West Nile virus (WNV) infection if the donor is from an endemic area. However, specific guidelines for screening were not provided, such as the optimal testing modalities, timing of screening prior to donation and the appropriate selection of donors. In this regard, the American Society of Transplantation Infectious Diseases Community of Practice, together with disease-specific experts, has developed this viewpoint document to provide guidance for the testing of live donors for Strongyloides, T. cruzi and WNV infection, specifically identifying at-risk populations and testing algorithms, including advantages, limitations and interpretation of results.
Introduction
Strongyloides, Trypanosoma cruzi and West Nile virus (WNV) are important pathogens that have been transmitted via deceased organ donors. Given the potential for transmission to result from living donation, the Organ Procurement and Transplantation Network (OPTN) mandated, effective February 2013, that transplant centers must test for evidence of infection with Strongyloides, T. cruzi and WNV if the potential live donor is from an endemic area. However, the policy does not provide specific guidance regarding implementation, including appropriate selection of donors for testing, optimal testing modalities and timing. Therefore, the American Society of Transplantation Infectious Diseases Community of Practice, in conjunction with disease-specific experts, has developed this viewpoint to provide guidance related to testing of live donors for these infections with a focus on the identification of at-risk populations, advantages and limitations of specific testing algorithms, and interpretation of results.
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