J Czerwiński, A Pszenny, M Łaba, K Ostrowski, M Pacholczyk, D Wasiak, M Kosieradzki, A Chmura, P Małkowski
Ann Transplant 2009; 14(1): 21-21
Available online: 2009-05-21
Background: To avoid viral transmission from the donor to recipient, several serological tests are obligatory (anti-HIV, anti-HCV, HBsAg) or strongly recommended (anti-HBc, anti-CMV) in the donor. There are some limitations of viral determination methods even when using new generations of ELISA-tests: detection limit is difficult to define, genotypes and different preparations of sample react differently. On the other hand the process of donor management is associated with alterations and disturbances in ï¬‚uid and electrolyte balance which, we suggest, may potentially inï¬‚uence viral testing to provide a percentage of false-negative or false-positive results. In order to explore the potentiality of erroneous determination of hepatitis B and C markers in cadaveric donors we designed a study of over 2000 donors with the following aims: - to assess and compare the incidence of positive/negative anti-HCV, HBsAg and anti-HBc results tested in the group of donors with low, normal or elevated hematocrite - to assess and compare the incidence of positive/negative anti-HCV, HBsAg and anti-HBc results tested in the group of donors with low-, normal or elevated osmolality .
Material/Methods: Between 2004 and 2007, 2435 possible deceased donors
were referred to Poltransplant. 1967 of them were effective. Anti-HCV antibodies were tested in 2185 and HBsAg in 2200 referred donors (including all effective cases). Anti-HBc was evaluated in 1183 referred donors, including 1087 in effective donors. In all studied donors the values of hematocrite (l/l) were recorded and osmolality (miliosmoles/kg) was calculated: P.OSM=2[NA] 2[K] [Urea] [Glucose]. Donors were stratified into groups with low (0.11-0.36), normal (0.36-0.44) and elevated (0.45-0.56) hematocrite and into groups with hypoosmolality (256-279), normal (280-300) and with hyperosmolality (301-404). A correlation between incidences of positive/negative results of viral markers was performed. Chi-test was used for statistical analysis, p-value of <0.05 were considered statistically significant.
Results: Among donors 61 (2.8%) tested anti-HCV(). In the group of donors with hematocrite 0.11 to 0.35 we observed a significantly lower incidence (2.2%, p=0.04) of negative tests. In the group with hypoosmolarity visibly higher percentage of positive tests were recorded (6.9%), but not significantly. HBsAg tests were positive in 15 cases (0.7%). Although in the group of donors with elevated hematocrite, hypo- and normal osmolality the numbers of HBsAg() were distinctly very low (0 or 1), it was not possible estimate the signifi cance due to small groups.
Keywords: Deceased Donor, viral infections