@article{Waller2022,

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

author = {Karen M J Waller and Nicole L De La Mata and Kate R Wyburn and James A Hedley and Brenda M Rosales and Patrick J Kelly and Vidiya Ramachandran and Karan K Shah and Rachael L Morton and William D Rawlinson and Angela C Webster},

doi = {10.1093/ofid/ofac337},

issn = {2328-8957},

year  = {2022},

date = {2022-08-02},

urldate = {2022-08-02},

volume = {9},

number = {8},

publisher = {Oxford University Press (OUP)},

abstract = {<jats:title>Abstract</jats:title>

               <jats:sec>

                  <jats:title>Background</jats:title>

                  <jats:p>Infections, including common communicable infections such as influenza, frequently cause disease after organ transplantation, although the quantitative extent of infection and disease remains uncertain.</jats:p>

               </jats:sec>

               <jats:sec>

                  <jats:title>Methods</jats:title>

                  <jats:p>A cohort study was conducted to define the burden of notifiable infectious diseases among all solid organ recipients transplanted in New South Wales, Australia, 2000–2015. Data linkage was used to connect transplant registers to hospital admissions, notifiable diseases, and the death register. Standardized incidence ratios (SIRs) were calculated relative to general population notification rates, accounting for age, sex, and calendar year. Infection-related hospitalizations and deaths were identified.</jats:p>

               </jats:sec>

               <jats:sec>

                  <jats:title>Results</jats:title>

                  <jats:p>Among 4858 solid organ recipients followed for 39 183 person-years (PY), there were 792 notifications. Influenza was the most common infection (532 cases; incidence, 1358 [95% CI, 1247–1478] per 100 000 PY), highest within 3 months posttransplant. Next most common was salmonellosis (46 cases; incidence, 117 [95% CI, 87–156] per 100 000 PY), then pertussis (38 cases; incidence, 97 [95% CI, 71–133] per 100 000 PY). Influenza and invasive pneumococcal disease (IPD) showed significant excess cases compared with the general population (influenza SIR, 8.5 [95% CI, 7.8–9.2]; IPD SIR, 9.8 [95% CI, 6.9–13.9]), with high hospitalization rates (47% influenza cases, 68% IPD cases) and some mortality (4 influenza and 1 IPD deaths). By 10 years posttransplant, cumulative incidence of any vaccine-preventable disease was 12%, generally similar by transplanted organ, except higher among lung recipients. Gastrointestinal diseases, tuberculosis, and legionellosis had excess cases among transplant recipients, although there were few sexually transmitted infections and vector-borne diseases.</jats:p>

               </jats:sec>

               <jats:sec>

                  <jats:title>Conclusions</jats:title>

                  <jats:p>There is potential to avoid preventable infections among transplant recipients with improved vaccination programs, health education, and pretransplant donor and recipient screening.</jats:p>

               </jats:sec>},

keywords = {Infectious Diseases, Oncology, SAFEBOD},

pubstate = {published},

tppubtype = {article}

}

@article{Waller2020,

title = {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},

author = {Karen M. J. Waller and Nicole L. De La Mata and James A. Hedley and Brenda M. Rosales and Michael J. O'Leary and Elena Cavazzoni and Vidiya Ramachandran and William D. Rawlinson and Patrick J. Kelly and Kate R. Wyburn and Angela C. Webster},

doi = {10.1111/tid.13437},

issn = {1399-3062},

year  = {2020},

date = {2020-12-00},

urldate = {2020-12-00},

journal = {Transplant Infectious Dis},

volume = {22},

number = {6},

publisher = {Wiley},

abstract = {<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Blood‐borne viral infections can complicate organ transplantation. Systematic monitoring to distinguish donor‐transmitted infections from other new infections post transplant is challenging. Administrative health data can be informative. We aimed to quantify post‐transplant viral infections, specifically those transmitted by donors and those reactivating or arising new in recipients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We linked transplant registries with administrative health data for all solid organ donor‐recipient pairs in New South Wales, Australia, 2000‐2015. All new recipient notifications of hepatitis B (HBV), C (HCV), or human immunodeficiency virus (HIV) after transplant were identified. Proven/probable donor transmissions within 12 months of transplant were classified using an international algorithm.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of 2120 organ donors, there were 72 with a viral infection (9/72 active, 63/72 past). These 72 donors donated to 173 recipients, of whom 24/173 already had the same infection as their donor, and 149/173 did not, so were at risk of donor transmission. Among those at risk, 3/149 recipients had proven/probable viral transmissions (1 HCV, 2 HBV); none were unrecognized by donation services. There were no deaths from transmissions. There were no donor transmissions from donors without known blood‐borne viruses. An additional 68 recipients had new virus notifications, of whom 2/68 died, due to HBV infection.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>This work confirms the safety of organ donation in an Australian cohort, with no unrecognized viral transmissions and most donors with viral infections not transmitting the virus. This may support targeted increases in donation from donors with viral infections. However, other new virus notifications post transplant were substantial and are preventable. Data linkage can enhance current biovigilance systems.</jats:p></jats:sec>},

keywords = {Infectious Diseases, MODUS, Transplantation},

pubstate = {published},

tppubtype = {article}

}