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CASES

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?

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CASES

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  1. CASES Dr Deepak Bhonagiri

  2. 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?

  3. 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?

  4. 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?

  5. 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?

  6. 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?

  7. 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?

  8. 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?

  9. 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?

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