CASES Dr Deepak Bhonagiri

Intravenous Drug Use  28 yr old  Out of hospital arrest, found with IV needle in cubital fossa  Hypoxic brain injury, brain death diagnosed 19 days following initial presentation  What is the window period for BBV transmission?  What if there are urgent heart/lung/liver recipients?

Ex- IV drug user  45 yr old, Gr V subarachnoid haemorrhage  Family state that he had “hepatitis C” and was seeing doctor about it. Last seen re “hepatitis” 5 yrs ago. No records available  Serology return negative for HepC, Hep B and HIV  What are the false negative rates for serology?  Is NAT/PCR helpful in decision making in this setting? 

Hepatitis B  52 yr old Gr V subarachnoid haemorrhage  History of hepatitis B  Hep B surface antigen +  What is the rate of false positives for HBsAg?  Risk of transmission?

False positive?  56 yr old, intracranial haemorrhage on warfarin  Brain death diagnosed and organ donation and retrieval proceeds  Next morning VDRL result +  What do you do? How do you manage recipients?  What is the rate of false positive for VDRL?

Northern NSW  38 yr old female, large parietal CVA with bleeding into CVA leading to brain death  Family gives history of Ross river virus infection 14 yrs ago  How do you manage?  Do you wait for results of test to return before retrieval?  Do recipients need specific management?

Recipient becomes donor  32 yr old female recipient of lung transplant has hypoxic arrest due to likely CMV pneumonia  Considered for DCD  What is the risk of transmission of CMV to recipients?

Chicken Pox  26 yo with varicella pneumonia has a hypoxic cardiac arrest and is brain dead 2/7 later  She received 2 days of acyclovir at he time of referral for organ donation  What is the risk of transmission of VZV from this donor?

MRO  21 yr old with traumatic brain injury has a hypoxic cardia arrest and is brain dead  He is colonised with MRSA and VRE and is growing MRAB in sputum  What is the risk of transmission of MROs to the recipients?