MOLECULAR DIAGNOSTICS :: TRANSPLANT TESTING
The critical role of testing for transplant donors and recipients
By Robert S. Jones, DO, MS, FACP, FIDSA, CPE I in the world.1
n the fall of 2022, the United States reached a historic and critical milestone — its organ donation system surpassed 1 million organ transplants, more than any other country Each of these 1 million organs represents an
individual living with a condition that requires exceptional care. These patients must endure ongoing post-transplant monitoring, anti-rejection medications, and other therapies. Post-transplant, patients can require anywhere between 10 and 20 years of monitoring, on average, and will need as many as 500 diagnostic tests throughout their lives.2
Making this
process as convenient as possible, and eliminating barriers to receiving this testing, is essential for transplant patients to achieve the best health outcomes. Yet, this is only one piece of the larger transplant patient journey.
The rising trend of living donation for transplant patients In the United States, the most transplanted organs are the kidney, liver, heart, lungs, pancreas, and intestines. Some of these, like the heart, can only be transplanted from cadavers, or deceased donors. Others, like the kidney, can come from a living donor — a procedure that is often associated with more favorable outcomes, including lower risk of complications. Living donation is also associated with shorter hospital stays and related cost savings post-surgery. While most patients receive organs from cadavers, in 2021, over 6,500 transplants were performed from living donors — an increase of 14.2 percent over 2020.3 Furthermore, if a person is able to secure a living donor, it reduces their need to wait for a cadaver, saving not only their
36 | SEPTEMBER 2023
MLO-ONLINE.COM
life, but potentially the lives of other patients who may be waiting with them for the next available organ. Though living donation is most common in the case of kidney transplants, recent years have seen a rise in living donation for partial liver transplants, which are also associated with better outcomes as the less time a harvested liver is artificially preserved, the better.4 These trends have been made possible by the emergence of
new guidelines and further advancements in testing. As one example, providers now have improved methods to test donors and patients to determine match compatibility. This has helped match patients with HIV with donors who also have HIV, en- abling care for people who previously had limited access. Yet, this is only one piece of how providers can work together to improve ability to access services.5
Broadening convenient access to transplant services and eliminating barriers to testing Access to fast and convenient transplant testing services is vital for transplant donors and recipients. Testing provides invaluable insights to identify infectious diseases in donors and recipients, determine match compatibility, monitor transplant therapy response, and identify rejection. Given certain trans- plant therapies may suppress the immune system, testing is also crucial to identify pathogens to help prevent transmission from a donor. While patient compliance in testing is critical, several factors can impede a patient’s ability to receive testing, which can ulti- mately contribute to poor outcomes, such as late acute rejection.
117351875 © Pop Nukoonrat |
Dreamstime.com
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48
