Detection of serological markers of infection in cadaveric specimens

Abstract

The use of serological screening assays is critical in ensuring the safety of transplantations for recipients in regards to transmission of infectious agents. As there are a greater number of patients awaiting transplantation than there are human tissue and cell based products available, an alternative to living donors is required. One potential source is the retrieval of materials from deceased donors. The quality of cadaveric specimens for infectious disease testing may differ from living donor, potentially affecting serological screening results. The present study aimed to identify changes in venous blood samples of cadaver donors that may influence the accuracy of testing by determining the overall rate of plasma dilution, through measurement of serum albumin, immunoglobulins G and M, and total proteins. While there was a significant difference in the mean and variance of total protein concentration in cadaveric and control donors and a significant difference in the variance of albumin concentration in the two populations, no significant difference was found in the mean concentrations of IgG, IgM or albumin between these groups. The relationship between biochemical marker concentrations and post-mortem interval was not significant for any markers. These results support previously published data that suggest negligible dilution of markers of infection occurs after death.Screening for serological markers of infection in the specimens collected using the Abbott Architect platform revealed a greater number of reactive results for human immunodeficiency virus (HIV Ag/Ab), hepatitis C virus (anti-HCV) and hepatitis B virus (anti-HBc) than the general Sydney community. Clinical and analytical sensitivity was found to be comparable for inoculated cadaveric and random living donors for the Abbott Architect HIV Ag/Ab, anti-HCV, anti-HBc II and HBsAg assays, demonstrating the suitability of cadaveric specimens in the detection of serological markers of infection.From this study it can be said that specimens collected from deceased donors are comparable to living donors in terms of plasma concentration of biochemical and serological markers, and that while false-reactive results may be more frequent than in living donors, inhibition of these assays does not occur