Positive toxicology and reactive serology in tissue donors: a retrospective study over a 3-year period

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Positive toxicology and reactive serology in tissue donors: a retrospective study over a 3-year period Ellen Heck . Kristel Gruslin . Valerie Corder . W. Matthew Petroll . Jill Urban

Received: 11 June 2019 / Accepted: 6 March 2020 Ó The Author(s) 2020

Abstract Assessment of donor suitability and criteria development for tissue donation evaluation which appropriately addresses the risk factors for disease transmission, especially high risk for Hepatitis B or C, HIV or other transmissible diseases as defined by the Food and Drug Administration, FDA, is a continuing concern for tissue banks. The relationship of drug use, especially IV drugs, has been determined to be associated with an increased possibility of reactive serology (Centers for Disease Control and Prevention (USCDC) in Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Hepatitis C questions and answers for health professionals. https://www.cdc.gov/hepatitis/ hcv/hcvfaq.htm; Centers for Disease Control and Prevention (USCDC) in infectious diseases, opioids and injection drug use, 2018. https://www.cdc.gov/ pwid/opioid-use.html; HIH National Institute on Drug Abuse in Health Consequences of Drug Misuse, 2017. https://www.drugabuse.gov/related-topics/healthconsequences-drug-misuse). Therefore, prior drug use determined by medical social history screening frequently results in deferral of a potential donor even when the route of drug administration has not been E. Heck (&)  K. Gruslin  V. Corder  W. M. Petroll University of Texas Southwestern Medical Center, Dallas, TX, USA e-mail: [email protected] J. Urban Institute of Forensic Sciences Dallas County, Dallas, USA

determined to be intravenous. Because of the association of drug use in numerous cases, which come under Medical Examiner jurisdiction, a possible rule out of a number of otherwise suitable medical examiner cases could occur. This retrospective review of medical examiner cases, tissue bank referrals and tissue donors in a 3-year period examines the relationship, if any, between reactive serology and positive toxicology results. These results would appear to indicate assessment of donor medical social history screening is effective in reducing recovery of high-risk donors. Keywords Positive toxicology  Reactive serology  Potential tissue donors  Correlation of data

Introduction A retrospective examination of records of potential tissue referrals and recovered donors for a 3-year period, 2015–2017, were examined for the use of drugs as determined by toxicology screening and the finding of reactive serologies in this large urban medical examiner tissue donor population. Since these donations had proceeded prior to any toxicology results or reactive serologies, the medical social history information for these donors failed to indicate a potential for high risk for communicable disease. There were 318 donors in this category of medical

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examiner