O-102 * DONOR-TO-HOST TRANSMISSION OF INFECTION IN LUNG TRANSPLANTATION

Abstract

Objectives: The purpose of the study was to evaluate the impact of donor infection and the outcome of lung transplant recipients. Methods: We performed a retrospective study of 109 consecutive adult lung transplants between January 2011 and December 2012. Donor-to-host transmission of infection was defined as any infection in the recipient due to at least one micro-organism also isolated from the donor, considered the same when the antimicrobial susceptibility patterns were identical. Results: Donors were 52% female (mean age 51 years). Mean ICU stay of 2.4 (range 0.5-15) days with a mean pO2 of 461 (range 322-636) mmHg. Almost 40% of the donors were active smokers at the moment of the offer. Types of donor infection included graft respiratory colonization (n = 66), contamination of preservation fluids (n = 42) and bacteraemia (n = 6). Donors older than 60 years and donors with history of tobacco abuse were related to have more graft respiratory colonization (75 % vs 54.2%, P = 0.036 and 74.4 % vs 52.3%, P = 0.021 respectively). Perioperative mortality was higher in recipients with positive graft colonization (10.6% vs 0%, P = 0.029). A positive graft respiratory colonization was related to a significant increase in death during hospitalization (15.2 % vs 2.4 %, P = 0.032). Donor-to-host transmission of infection occurred in 9 (8.2%) lung allograft recipients. Among these cases only one patient died because of infection 30 days after surgery (pneumonia due to Staphylococcus aureus). Conclusions: Even though the rate of transmission of infection is low, the presence of a positive graft respiratory colonization in lung donors was found to have a poor outcome. Older donors and tobacco abuse was also found to play an important role in respiratory tract colonization.