Infections detected in English surgical bone and deceased donors (2001-2006) and estimated risk of undetected hepatitis B and hepatitis C virus

Background and Objectives: Infections can be transmitted through donated tissue products, such as femoral heads. Here we describe infections detected through microbiological testing of English surgical bone and deceased donors (2001-2006) and estimate the residual risk of infection. Materials and Methods: Data on infected tissue donors identified by NHS Blood and Transplant (NHSBT) were collected through the NBS/Health Protection Agency Infection Surveillance programme. The blood donor model for estimating risk was adapted for tissue donors. Incidence among surgical bone donors was derived from new blood donor data and estimates of residual risk presented for surgical bone donors only. Results: Fifty-seven surgical bone and four deceased donors were identified with 60 and five infections, respectively, during the 6 years. Syphilis was the most common infection detected, with no human T-lymphotropic virus infections and one HIV infection in a deceased donor. Hepatitis B virus, hepatitis C virus and syphilis prevalence was higher among surgical bone and deceased donors than new blood donors for the same period. The overall estimated risk of undetected hepatitis B and hepatitis C virus among surgical bone donors (2001-2006) on initial screening was 0·426 and 0·048 per 100 000 donors, respectively. Testing a follow-up sample made these risks almost negligible. Conclusion: The prevalence of infections was low among English tissue donors. Risk estimates were higher for surgical bone donors on first screening than among new blood donors. However, the probability of an infectious donation entering the tissue supply became negligible after obtaining a follow-up sample 6 months post-donation and were well below that of new blood donors.