Organ Donor Infectious Disease Testing Education

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Organ Donor Infectious Disease Testing Education

• UW Health OPO
• July 2009

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UW health OPO performs the following infectious
disease testing in compliance with the United
Network for Organ Sharing (UNOS) standards for
every donor

• HIV I/II
• HTLV I/II
• Anti-HBc (Hepatitis B Core)
• HBsAg (Hepatitis B surface antigen)
• HCV (Hepatitis C)
• VDRL/RPR (Syphilis)
• CMV (Cytomegalovirus)
• EBV (Epstein-Barr Virus)

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Current Challenges

• Early 2008 Abbott labs discontinued FDA
  approved kit used by UWHC for Hepatitis B,
  Hepatitis C HIV
• UW Health OPO given exemption by UNOS to perform
  diagnostic testing, Centaur

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Current Status

• Donor serological testing is generally done at UW
  via diagnostic method.
• Only exception is in the case of a potential
  islet donor. These panels are sent to BCW
  (BloodCenter of Wisconsin) for FDA approved
  serologies.
• July 1, 2009 All donor serological testing will
  be done at BCW, including NAT and WNV.
• The only blood testing done at UW will be ABO
  verification, EBV (send out) and HLA.

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BloodCenter of Wisconsin

• Open since 1947 and located in Milwaukee, WI
• On call staff enables donor testing 24 hrs a day
  365 days a year
• Approved for NAT testing on all donors

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NAT Testing

• The industry standard is changing with regard to
  infectious disease testing.
• NAT (Nucleic Acid Testing) detects the genetic
  sequence of the virus, bacterium or parasite that
  is present in the host as a result of the
  infection.
• It is used for HIV, HCV, HBV and West Nile Virus.
• NAT shortens the window of detection for HIV
  HCV from approximately 22 days to 5 days and for
  HBV and WNV to 1 day.
• Currently 45 out of the 58 OPOs are performing
  NAT.

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New Process

• Initial donor blood draw will now need to be
  shipped in 2 packages
• Package 1sent to BloodCenter of WI
• 3 7 ml EDTA (lavender) tubes
• 2 10 ml serum sample (red topNOT serum
  separator) tubes
• Package 2sent to UW
• 4 10 ml ACD (yellow top) tubes
• 1 5 or 7 ml lavender tubes

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New Process

• For each bag
• Affix a label including patients first and last
  name, date of birth, date and time of draw and
  initials of person drawing
• Place the tubes in a biohazard bag and then
  package in a small box or envelope
• Write To BloodCenter of WI on package 1
• To UW Hospital ER on package 2

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New Process

• Take samples to your ER triage
• A courier will be arranged to transport the
  samples from your ER to their destination
• Please call organ procurement coordinator on call
  with any questions 608-262-2122

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New Timeline

• Once blood arrives to BCW serology testing takes
  4-6 hrs to complete if any results are positive
  the test needs to be re-run and take an
  additional 4-6 hrs
• Once blood arrives to UW ER
• ABO takes under an hour
• EBV needs to be sent out and results arrive in 5
  to 7 days
• HLA (tissue typing) takes about 4 hours

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• Thanks for your assistance!!