Impact of donor bacteremia on outcome in organ transplant recipients

CommentsAn estimated 5% of the organ donors have been shown to be bacteremic at the time of organ procuremen.1,2 Although bacteremia and bacterial infections in the donor pose a potential risk for the transmission of infection to the recipient, discarding life-saving organs from such donors could further compromise the already limited donor pool and aggravate the organ donor shortage.Therefore, discerning whether organs from bacteremic donors can be safely used for transplantation and the appropriate management of the recipient have significant clinical implications.The risk of donor-transmitted infection varies with the type of bacteria causing the infection.Bacteremia caused by gram-negative bacilli in the donor has been shown to pose a greater risk for transmission and is associated with poorer outcomes than that caused by gram-positive bacteria.3 Infectious complications occurred in two of three recipients who received hearts from donors who had gram-negative bacteremia as compared with none of the 16 in the patients whose donors had gram-positive bacteremia. 3Donor bacteremia caused by Serratia and Escherichia coli resulted in mediastinitis and sepsis in these two recipients in the aforementioned study and was associated with death in one.3 In the context of gram-positive bacteria, a low risk of transmission and infection with relatively avirulent bacteria, e.g., Staphylococcus epidermidis is not surprising.S.