Transcript Organ Donor Infectious Disease Testing Education

Organ Donor Infectious Disease
Testing Education
UW Health OPO
July 2009
UW health OPO performs the following
infectious disease testing in compliance with
the United Network for Organ Sharing
(UNOS) standards for every donor:
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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)
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
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.
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
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.
New Process
• Initial donor blood draw will now need to
be shipped in 2 packages
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Package 1—sent to BloodCenter of WI
3 7 ml EDTA (lavender) tubes
2 10 ml serum sample (red top—NOT serum
separator) tubes
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Package 2—sent to UW
• 4 10 ml ACD (yellow top) tubes
• 1 5 or 7 ml lavender tubes
New Process
• For each bag
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Affix a label including patient’s 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
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 rerun and take an additional 4-6 hrs
• Once blood arrives to UW ER
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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
Thanks for your
assistance!!