Pretransplantation Infectious Disease Screening for Liver Transplantation: Candidates and Donors

Abstract Introduction: A commitment of CB banks is to test CB units and maternal blood for multiple genetic and infectious disease markers. As a consequence, several aliquots of blood, mononuclear cells and plasma are taken during processing for immediate and delayed testing. Whereas control of identity between aliquots containing cells can be performed by DNA assays, identity controls for plasma aliquots rely only on bar-coded label systems. We hypothesize that there is soluble extra-cellular DNA (EC-DNA) and that it can be used for identity control of plasma aliquots. The aims of our study were; to determine the concentration of EC-DNA in CB-plasma, to evaluate whether genetic identity testing by STR analysis is feasible and to investigate whether EC-DNA allows infectious disease screening by nucleic acid testing (NAT). Methods: CB (n=20) was collected, processed (Rubinstein et al, PNAS 1995) and EC-DNA from 200 μl of 0.45μm-filtered plasma was extracted both with the Qiagen and the High Pure Viral Nucleic Acid method (Roche). Presence of EC-DNA was evaluated by detection of HLA-DR and ALU gene sequences and by STR analysis (AmpFlSTR-Profiler Plus-Applied Biosystems). Purified HBV was added to CB and peripheral blood (PB) plasma, EC-DNA recovered as above and HBV-DNA assessed by real time PCR. Results: All 20 samples were positive for HLA-DR by PCR and for ALU sequence by real time PCR, confirming the presence of EC-DNA in CB-plasma in concentrations of 0.022 +/− 0.012 ng/μl at the time of CB collection, rising to 0.124 +/− 0.025 ng/μl 33 hrs later; p<0.016. Concentrations observed in CB-plasma were higher than those of adult donor plasma (PB-plasma 0.005+/−0.0065 ng/μl). STR analysis was validated on cellular DNA and, when applied for EC-DNA, showed good signal strengths and low backgrounds, allowing accurate automatic allele identification with no manual corrections (genemapper software, Applied Biosystems). An increase in STR-PCR product concentration was observed when we analyzed EC-DNA samples from CB after 33hs (7017.6 +/− 2014 RFU/μl at time of CB collection and 30290.9 +/− 3164 RFU/μl after 33 hs; RFU = relative fluorescence units). HBV was recovered from all spiked units, in correspondence with the viral concentrations added. Recovery of HBV was 96 +/− 21% with high and low viral concentrations. Three mothers with HBAg/HBcore positive had also HBV-DNA in PB-plasma. Six with anti-HBcore only and 70 with anti-HBs were negative. HBV-DNA was also negative in CB-plasma for all seventy nine respective newborns. Conclusions: there is infant EC-DNA in CB-plasma and viral nucleic acids can be obtained using the same extraction method. There is an increase of EC-DNA in CB over time that may reflect cell death. STR assay of EC-DNA can be a useful molecular tool for the identification of plasma aliquots used for infectious disease testing in CB banks.

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Engaging New Migrants in Infectious Disease Screening: A Qualitative Semi-Structured Interview Study of UK Migrant Community Health-Care Leads

PLoS ONE ◽

10.1371/journal.pone.0108261 ◽

2014 ◽

Vol 9 (10) ◽

pp. e108261 ◽

Cited By ~ 34

Author(s):

Farah Seedat ◽

Sally Hargreaves ◽

Jonathan S. Friedland

Keyword(s):

Infectious Disease ◽

Health Care ◽

Community Health ◽

Structured Interview ◽

Disease Screening ◽

Interview Study ◽

Community Health Care ◽

Migrant Community

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Improving Competency of Community Health Workers in Non-Infectious Disease Screening in Sleman, Improving Competency of Community Health Workers in Non-Infectious Disease Screening in Sleman, Yogyakarta

Reaching the Unreached: Improving Population Health in the Rural and Remote Areas ◽

10.26911/theicph.2018.01.21 ◽

2018 ◽

Author(s):

Sri Arini Winarti ◽

◽

Keyword(s):

Infectious Disease ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Disease Screening

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Many-Persons-To-1-Test-Kit Infectious Disease Screening—Abridged Version

10.21203/rs.3.pex-893/v1 ◽

2020 ◽

Author(s):

Hiok Nam Tay

Keyword(s):

Infectious Disease ◽

Disease Screening ◽

Cohort Size ◽

University Campuses ◽

Target Populations ◽

Cruise Ships ◽

Health Authorities ◽

Test Kit

Abstract COVID-19 has forced many cities and countries to restrict commerce and movement of people, causing unprecedented loss of economy. Protracted lockdown may become unavoidable as health authorities have no means to isolate all infected individuals because existing testing capacities are very small compared with entire populations.We propose here a new screening methodology that greatly expands the size of the screened cohort beyond given testing capacity. This is an abridged version of the full multiplier grid (MG) methodology paper.With expanded screening cohort size, entire highrise residential complex can be screened 20X faster, and the same test capacity can screen 20X as many residential complexes. The same methodology can be applied to factories, villages, towns, university campuses, office towers, cruise ships, etc. The exact multiplier varies between target populations and can be larger.

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PRETRANSPLANT INFECTIOUS DISEASE SCREENING OF DONORS AND RECIPIENTS FROM ENDEMIC REGIONS

Transplantation Journal ◽

10.1097/00007890-201007272-00222 ◽

2010 ◽

Vol 90 ◽

pp. 115

Author(s):

A. A. Dowton ◽

C. N. Kotton

Keyword(s):

Infectious Disease ◽

Disease Screening

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Infectious disease screening in asylum seekers: range, coverage and economic evaluation in Germany, 2015

Eurosurveillance ◽

10.2807/1560-7917.es.2017.22.40.16-00677 ◽

2017 ◽

Vol 22 (40) ◽

Cited By ~ 15

Author(s):

Kayvan Bozorgmehr ◽

Katharina Wahedi ◽

Stefan Noest ◽

Joachim Szecsenyi ◽

Oliver Razum

Keyword(s):

Infectious Disease ◽

Economic Evaluation ◽

Hepatitis B ◽

Asylum Seekers ◽

Disease Screening ◽

Economic Evaluations ◽

Federal States ◽

Immunodeficiency Virus ◽

Per Capita ◽

Cost Differences

Screening asylum seekers for infectious diseases is widely performed, but economic evaluations of such are scarce. We performed a policy analysis and economic evaluation of such screening in Germany, and analysed the effect of screening policies on cost differences between federal states. Of the 16 states, screening was compulsory for tuberculosis (TB) in asylum seekers ≥ 16 years of age in all states as well as in children < 16 years of age and pregnant women in six states, hepatitis B and enteropathogens in three, syphilis in two and human immunodeficiency virus (HIV) in one state. Of 441,899 asylum seekers, 88.0% were screened for TB, 22.9% for enteropathogens, 16.9% for hepatitis B, 13.1% for syphilis and 11.3% for HIV. The total costs for compulsory screening in 2015 were 10.3 million euros (EUR). Costs per case were highest for infections with Shigella spp. (80,200 EUR), Salmonella spp. (8,000 EUR), TB in those ≥ 16 years of age (5,300 EUR) and syphilis (1,150 EUR). States with extended screening had per capita costs 2.84 times those of states that exclusively screened for TB in asylum seekers ≥ 16 years of age (p < 0.0001, 95% confidence interval (CI): 1.96–4.10). Screening practices in Germany entailed high costs; evidence-based approaches to infectious disease screening are needed.

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