Infectious disease screening of blood specimens collected post-mortem provides comparable results to pre-mortem specimen
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Infectious disease screening of blood specimens collected post-mortem provides comparable results to pre-mortem specimens Cristina Baleriola • Harpreet Johal • Peter Robertson Brendan Jacka • Ross Whybin • Peter Taylor • William D. Rawlinson
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Received: 1 November 2010 / Accepted: 18 March 2011 / Published online: 8 April 2011 Ó Springer Science+Business Media B.V. 2011
Abstract Serology assays for standard screening are optimised for use with sera collected from living adults and children. Because of potential changes in the vascular compartments after death, methods used for screening sera from cadaveric organ donors need to be validated before testing these specimens. Serum was separated from blood collected from cadaveric donors within 24 h of death and biochemical parameters measured to detect dilution of protein and haemolysis. In order to demonstrate if any inhibitors that might interfere with the assays were present, pre and post-mortem specimens were spiked with aliquots of human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), human T-cell Lymphotropic Virus (HTLV) and
C. Baleriola H. Johal W. D. Rawlinson (&) Virology Division, SEALS, Prince of Wales Hospital, Randwick, Sydney, NSW 2031, Australia e-mail: [email protected] P. Robertson R. Whybin Serology Laboratory, SEALS, Prince of Wales Hospital, Sydney, Australia P. Taylor Department of Microbiology, Prince of Wales Hospital, Sydney, Australia B. Jacka National Centre in HIV Epidemiology and Clinical Research, Sydney, Australia
T. pallidum-positive sera. Comparison of serum from living subjects with serum obtained post-mortem showed that while the concentration of total protein decreased, concentrations of albumin, immunoglobulin G (IgG) and immunoglobulin M (IgM) remained unchanged. The degree of haemolysis, as measured by free haemoglobin, was within the limits accepted for the Architect analyser. Spiking of pre- and postmortem specimens with aliquots of HIV, HCV, HBV, HTLV and T. pallidum-positive sera showed no statistical difference in the signal between premortem and post-mortem results when tested on the Abbott Architect analyser. Positive results were obtained in each of a further nine subjects who had tested positive for HIV (n = 1), HCV (n = 8), HBV (n = 1) on pre-mortem serological testing. These findings suggest that the sensitivity of the Abbott Architect serological screening tests is not significantly affected in specimens collected within 24 h of the cessation of life. Keywords Donor Screening Post-mortem Blood Virology
Introduction Cadavers remain the major source of donor organs and tissues worldwide. These include corneas, lungs, hearts, other cardiovascular material, musculoskeletal
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material (bone, tendon), liver, pancreas, small bowel, kidney and bone marrow (Yao et al. 2007). Retrieval of organ and tissues from deceased donors introduces unique challenges in testing for markers of infectious disease, particularly in the case of tissue donors where cadaveric blood
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