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Transplant Safety








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			Can you get sick from a transplant?How do hospitals get organs and tissues?What are screening and testing requirements for organ and tissue donation?What are the reporting requirements for organs and tissues with suspected infections?
		
Can you get sick from a transplant?The body views transplanted organs (kidneys, liver, lung, heart, pancreas, and intestines) as foreign and will attack them. This is called ‘rejection.’ To prevent this response, certain medications are given to the organ recipient. A side effect of these medications is that the body cannot fight off infection as easily as a healthy person.
In contrast, most types of transplanted tissues (i.e., bone, tendons, heart valves and cornea) are not recognized as foreign because they do not have an internal vascular system, like organs do.  Therefore, immune cells and antibodies that travel through blood do not attack the tissue and medications to suppress the immune system are not needed.How do hospitals get organs and tissues?Hospitals are required to have written agreements with organizations that coordinate organ and tissue donation and recovery. There are 57 organ procurement organizations (OPOs) and a larger number of tissue recovery and eye recovery banks that work with hospitals in the United States for this purpose.  Hospitals also obtain organs (kidneys and livers) from living donors.What are screening and testing requirements for organ and tissue donation?Organ and tissue recovery organizations are required to obtain a medical and social history of deceased donors by asking their next-of-kin, and sometimes other persons who knew the potential donor, questions about: 1) behaviors that may have exposed the potential donor to certain diseases and 2) the potential donor’s past medical history.  This questionnaire serves as one of several resources to assess the donor’s risk for having a disease.
Hospitals are required to evaluate living potential donors for the presence of behaviors or medical history that may increase the risk of infection in the donor.
OPOs, tissue banks, and eye banks are also required to perform certain tests to see if the potential donor may have infections, such as human immunodeficiency virus (HIV),  hepatitis B or hepatitis C virus, syphilis and cytomegalovirus (CMV). These test results are provided to the healthcare facility where transplantation of the organ or tissue will occur.Top of PageWhat are the reporting requirements for organs and tissues with suspected infections?Organ Procurement and Transplantation Network (OPTN) policy requires OPOs to report suspected donor-derived disease transmissions to the OPTN and to notify all transplant centers that received organs from the same donor.  Additionally, OPOs must contact tissue banks and eye banks that recovered tissues from that same donor.
Tissue and eye banks are required to investigate suspected communicable disease transmissions related to tissue.  If the recipient infection seems likely to have been caused by the transplanted tissue and meets other criteria (i.e., fatal, life-threatening, permanent damage to body, or requires medical or surgical intervention), the tissue or eye bank that released the tissue must submit findings to the FDA through its MedWatch surveillance system.  Healthcare facilities that perform these transplants are encouraged to report suspected transmissions to the tissue supplier and through the MedWatch system. Reporting is voluntary.
Organ and tissue recovery organizations and transplant centers and hospitals recovering from the living donor are also required to notify local or state public health authorities when a donor is confirmed to have an infection that is considered a notifiable infectious disease. Each state maintains a list of notifiable diseases, which can be found on their state health department’s website.Top of Page
							
					
							Last Reviewed:  October 13, 2022						Source: 	Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP)
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