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Donor-derived Viral Infections in Liver Transplantation

Nam, Hannah, MD1; Nilles, Kathy M., MD2; Levitsky, Josh, MD3,4; Ison, Michael G., MD1,4

doi: 10.1097/TP.0000000000002326

Donor-derived infections are defined as any infection present in the donor that is transmitted to 1 or more recipients. Donor-derived infections can be categorized into 2 groups: “expected” and “unexpected” infections. Expected transmissions occur when the donor is known to have an infection, such as positive serology for cytomegalovirus, Epstein Barr virus, or hepatitis B core antibody, at the time of donation. Unexpected transmissions occur when a donor has no known infection before donation, but 1 or more transplant recipients develop an infection derived from the common donor. Unexpected infections are estimated to occur in far less than 1% of solid organ transplant recipients. We will review the epidemiology, risk factors, and approaches to prevention and management of donor-derived viral infectious disease transmission in liver transplantation.

The authors of this review provide an update on donor-derived viral infections in liver transplantation, highlighting risk of disease transmission and potential strategies to mitigate this risk or its consequences.

1 Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL.

2 Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, CO.

3 Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, IL.

4 Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, IL.

Received 24 March 2018. Revision received 7 May 2018.

Accepted 31 May 2018.

H.N. and K.M.N. declare no conflicts of interest. J.L. is a paid speaker for Gilead and Novartis. M.G.I. has received support for research, paid to Northwestern University from Beckman Coulter, Cephied, Chimerix, Emergent BioScience, Gilead, Janssen, and Shire; compensated consultation from Chimerix, Celltrion, Genentech/Roche, MediVector, Seqirus, Shionogi, and VirBio; and paid membership of DSMB from GlaxoSmithKlein, Shionogi.

H.N. and K.M.N. are co-first authors. Both have made substantial contributions in gathering information necessary in drafting the article, participated in writing the article, and revised it critically for important intellectual content. J.L. and M.G.I. have revised the article critically for important intellectual content and gave final approval of the version to be submitted, as well as any revised versions.

Correspondence: Michael G. Ison, MD, Divisions of Infectious Diseases and Organ Transplantation, Northwestern University Feinberg School of Medicine, 645N Michigan Avenue Suite 900, Chicago, IL 60611. (

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