Analysis and the results of serological testing of Croatian organ donors from 2006 to 2012

Abstract

Uvod: Uspješnost transplantacije i preživljavanja presatka usko su povezani s odsustvom infekcije u primatelja. Infekcija primatelja je posljedica infekcije presatkom, reaktivacije latentnih infekcija primatelja, nozokomijalnih infekcija i kasnije, zbog doživotne imunosupresije infekcija iz okoline. Hrvatski zavod za transfuzijsku medicinu (HZTM) od 2006. provodi obvezna testiranja donora organa (DO) na uzročnike krvlju prenosivih bolesti (24h/7 dana) za potrebe cijele Hrvatske. Materijal i metode: U razdoblju od 5.11.2006. – 31.12.2012. ispitano je u HZTM 642 uzoraka plazme DO pri čemu su korišteni testovi Abbott – Architect i bioMerieux – Vidas. U ovom radu analizirani su kvaliteta uzorka, brzina i rezultati testiranja na biljege infekcije virusima humane imunodeficijencije 1 i 2 (HIV), virusima hepatitisa B (HBV) i C (HCV), citomegalovirusom (CMV), Epstein-Barr virusom (EBV), T. pallidum i T. gondii. Rezultati: Seroprevalencija EBV, CMV i T. gondii očekivano je visoka i iznosi 96,8%, 92% i 71%. HIV pozitivnih među DO nije bilo, a biljege HBV infekcije, HBsAg i antitijela na HBcAg (anti-HBc) imalo je 0,5% odnosno 8,9% DO. U 1,3% ispitanih dokazan je HCV antigen, a antitijela na virus hepatitisa C (anti-HCV) bila su pozitivna u njih 1,6%. Učestalost treponemskih antitijela bila je 0,8%. 2,5% uzoraka bilo je razrijeđeno više od 50%, a prosječno vrijeme testiranja DO bilo je 2,04 sata. Zaključak: Rezultati testiranja DO upućuju na primjerenost odabranih testova i algoritama testiranja kao i metoda selekcije DO u donorskim bolnicama, a prevalencije patogena sukladne su epidemiološkim karakteristikama opće populacije.Introduction: The success of transplantation and graft survival are closely related to the absence of infection in transplant recipients through infected graft, reactivated recipient\u27s latent infections, nosocomial infections and community acquired infections. Since 2006, the Croatian Institute of Transfusion Medicine has been providing mandatory testing of organ donors (OD) for bloodborne pathogens (24/7) for the entire country. Materials and methods: In the period from 5.11.2006. to 31.12.2012. a total of 642 organ donor plasma samples were tested by means of Abbott – Architect and bioMerieux – Vidas tests. In this paper, the quality of samples measured against rate of dilution, turnaround time and prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), T. pallidum and T. gondii markers were analyzed. Results: Seroprevalence of EBV, CMV and Toxoplasma gondii was as high as expected (96.8%, 92% and 71%, respectively). There were no HIV positive OD, while in 0.5% HBsAg, in 8.9% anti-HBc, in 1.6% anti-HCV, in 1.3% HCVAg and in 0.8% T. pallidum Ab were found positive. 2.5% of the samples were diluted by more than 50% and the average testing time per OD was 2.04 hours. Conclusion: The results indicate the adequacy of organ donor selection methods in donor hospitals, appropriate tests and testing algorithms used. The prevalence of pathogens is in accordance with epidemiological characteristics of the general population