Ad Hoc Disease Transmission Advisory Committee (DTAC) Update Hello Everyone, my name is ____________ from [name of organization]. I am a member of the Ad Hoc Disease Transmission Advisory Committee or DTAC. First I am going to give you a quick reporting update. Then I will the “Clarify Informed Consent of Transmittable Conditions” public comment proposal. Spring 2018

Questions about reporting potential HCV donor-derived transmissions Report to the Improving Patient Safety Portal: Donor is HCV antibody positive, NAT negative and recipient converts post-transplant to either HCV antibody or NAT positive Donor is either HCV antibody or NAT positive and recipient converts post-transplant to HCV antibody positive but is NAT negative Do not report when donor is HCV NAT positive and recipient converts to HCV NAT positive Questions have come up about reporting potential HCV donor derived transmission. We want to clarify what should be reported to the OPTN through the Improving Patient Safety portal. Before we had the ability to record nucleic acid (NAT) results in DonorNet we did not ask for reports when the donor was HCV positive prior to transplant and the recipient then converted to HCV positive post-transplant because those were viewed as “expected” transmissions. However, now that we can distinguish between NAT and antibody in DonorNet, we request reporting when the following occurs: Donor is HCV antibody positive, NAT negative and recipient converts post-transplant to either HCV antibody or NAT positive Donor is either HCV antibody or NAT positive and recipient converts post-transplant to HCV antibody positive but is NAT negative These are unexpected occurrences that we are now hearing about more recently. In order to better understand these occurrences, DTAC and CDC are currently collaborating on reviewing these cases and we plan to provide an update to the transplant community regarding these situations which at this point we are considering “unexpected” transmissions. Members do not need to report when the donor is HCV NAT positive and the recipient converts to HCV NAT positive after transplant. This is an expected transmission.

Questions? Cameron Wolfe, MBBS(Hons), MPH, FIDSA Ad Hoc Disease Transmission Advisory Committee Chair cameron.wolfe@duke.edu Susan Tlusty Ad Hoc Disease Transmission Advisory Committee Liaison Susan.tlusty@unos.org