Cost-effectiveness of Interventions to Increase Utilization of Kidneys From Deceased Donors With Primary Brain Malignancy in an Australian Setting

Kidneys from potential deceased donors with brain cancer are often foregone due to concerns of cancer transmission risk to recipients. There may be uncertainty around donors’ medical history and their absolute transmission risk or risk-averse decision-making among clinicians. However, brain cancer transmissions are rare, and prolonging waiting time for recipients is harmful. We assessed the cost-effectiveness of increasing utilization of potential deceased donors with brain cancer using a Markov model simulation of 1500 patients waitlisted for a kidney transplant, based on linked transplant registry data and with a payer perspective (Australian government).

See full text here: Cost-effectiveness of Interventions to Increase Utilization of Kidneys From Deceased Donors With Primary Brain Malignancy in an Australian Setting

Cost-effectiveness of Kidney Transplantation From Donors at Increased Risk of Blood-borne Virus Infection Transmission

A Markov model was developed using real-world evidence to compare healthcare costs and quality-adjusted life years (QALYs) of accepting kidneys from deceased donors with potential increased risk of BBV transmission, because of increased risk behaviors and/or history of HCV, versus declining these kidneys. Model simulations were run over a 20-y time horizon. Parameter uncertainty was assessed through deterministic and probabilistic sensitivity analyses.

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Notifiable Infectious Diseases Among Organ Transplant Recipients: A Data-Linked Cohort Study, 2000–2015

After organ transplantation, infections, including common communicable infections such as influenza, frequently cause disease, although the actual amount of infection and disease is unclear.

We aimed to measure the burden of notifiable infectious diseases in an Australian cohort of transplant recipients compared with the general population.

See full text here: Notifiable Infectious Diseases Among Organ Transplant Recipients: A Data-Linked Cohort Study, 2000–2015

Potential organ donors with primary brain tumours: missed opportunities for donation and transplantation identified in Australian cohort study 2010–2015

Potential organ donors with primary brain tumours (PBT) frequently donate, however some may be declined due to uncertainty about tumour classification or transmission risk to transplant recipients. We sought to describe transmission risk and donation outcome of potential donors with PBT, including identifying missed opportunities for transplantation, and any PBT transmission events.

See full text here: Potential organ donors with primary brain tumours: missed opportunities for donation and transplantation identified in Australian cohort study 2010–2015

Notifiable Infectious Diseases Among Organ Transplant Recipients: A Data-Linked Cohort Study, 2000–2015

A cohort study was performed among all solid organ recipients in NSW, Australia, transplanted from 2000 to 2015. This was used to estimate the burden of notifiable infectious diseases compared to the general population.

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Perceived Versus Verified Cancer History and Missed Opportunities for Donation in an Australian Cohort of Potential Deceased Solid Organ Donors

We aimed to establish the accuracy of health information known at the time of donation decisions, by comparing the perceived cancer diagnoses in donor logs with verified diagnoses from linked health records. Secondly, we aimed to identify any missed donor opportunities (suitable donors who were declined) and excess-risk donors (unsuitable donors who were accepted). Finally, we aimed to evaluate potential strategies to avoid missed donor opportunities through support in following clinical guidelines, improving quality of available information, and varying risk tolerance thresholds.

Find full text here: Perceived Versus Verified Cancer History and Missed Opportunities for Donation in an Australian Cohort of Potential Deceased Solid Organ Donors

Cancer transmissions and non-transmissions from solid organ transplantation in an Australian cohort of deceased and living organ donors

 We sought to identify cases of cancer transmission or non-transmission from transplantation in an Australian cohort of donors and recipients. We included NSW solid organ deceased donors 2000-2012 and living donors 2004-2012 in a retrospective cohort using linked data from the NSW Biovigilance Register (SAFEBOD). Central Cancer Registry (CCR) data 1972-2013 provided a minimum one-year post-transplant follow-up. We identified cancers in donors and recipients. For each donor-recipient pair, the transmission was judged likely, possible, unlikely, or excluded using categorization from international guidelines. In our analysis, transmissions included those judged likely, while those judged possible, unlikely, or excluded were non-transmissions. In our cohort, there were 2502 recipients and 1431 donors (715 deceased, 716 living). There were 2544 transplant procedures, including 1828 (72%) deceased and 716 (28%) living donor transplants. Among 1431 donors, 38 (3%) had past or current cancer and they donated to 68 recipients (median 6.7-year follow-up). There were 64 (94%) non-transmissions, and 4 (6%) transmissions from two living and two deceased donors (all kidney cancers discovered during organ recovery). Donor transmitted cancers are rare, and selected donors with a past or current cancer may be safe for transplantation.

Find full text here: Cancer transmissions and non-transmissions from solid organ transplantation in an Australian cohort of deceased and living organ donors

Characteristics and Donation Outcomes of Potential Organ Donors Perceived to be at Increased Risk for Blood Borne Virus Transmission: An Australian Cohort Study 2010-2018

With hepatitis C (HCV) curative therapy, more potential donors may now be suitable. We sought to describe potential deceased donors with increased BBV transmission risk. We conducted a cohort study of all potential organ donors referred in New South Wales, Australia, 2010-2018. We compared baseline risk potential donors to potential donors with increased BBV transmission risk, due to history of HIV, HCV or hepatitis B and/or behavioural risk factors.

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New blood-borne virus infections among organ transplant recipients: An Australian data-linked cohort study examining donor transmissions and other HIV, hepatitis C and hepatitis B notifications

We aimed to quantify post-transplant viral infections, specifically those transmitted by donors and those reactivating or arising new in recipients.

Find full text here: New blood-borne virus infections among organ transplant recipients: An Australian data-linked cohort study examining donor transmissions and other HIV, hepatitis C and hepatitis B notifications, 2000-2015

Safety and Biovigilance in Organ Donation (SAFEBOD): Protocol for a Population-Based Cohort Study

The Safety and Biovigilance in Organ Donation (SAFEBOD) study aims to improve estimates of infection and cancer transmission risk and explore how real-time data access could support decision-making.

Find the full text here: Safety and Biovigilance in Organ Donation (SAFEBOD): Protocol for a Population-Based Cohort Study

Residual risk of infection with blood‐borne viruses in potential organ donors at increased risk of infection: systematic review and meta‐analysis

When potential donors are referred for consideration, if there is potential that they have an infection that could be transmitted to any organ transplant recipients, that donor is usually declined. Our work showed that they are often declined even when tests don’t show these infections. Infections like human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) are important to exclude. This paper looked at the risk of a potential donor having one of these infections, if all the tests done at the time they were being considered to donate, tested negative for infection. We found the risks were very low and concluded that accepting organ donations by people at increased risk of infection but with negative viral test results could be considered as a strategy for expanding the donor pool.

Find the text here: Residual risk of infection with blood‐borne viruses in potential organ donors at increased risk of infection: systematic review and meta‐analysis