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Residual risk of undetected blood-borne virus infection in deceased organ donors: Residual risk visualiser website

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posted on 2025-01-31, 13:16 authored by Martin DutchMartin Dutch, ROBERT MAILLARDETROBERT MAILLARDET, JONATHAN KNOTTJONATHAN KNOTT

Risk of Unexpected Donor Infection: Quarantine Adjusted Window Period Visualisation Tool

Before donation, deceased organ donors are screened for blood-borne viruses. Recent infections may not always be detected. This website assists in estimating the residual risk of undetected viral infection in increased viral risk donors who screen negative for blood-borne virus using a combination of both nucleic acid testing and serology.

The website allows users to select the virus of interest and the minimum infective concentration. Default viral incidence rate values for Australia and North America are included. Assay performance is based on a commonly used commercial assay. The algorithm uses previously published viral doubling times.

The website produces a dynamically interactive graph of the residual risk and the numeric risk of undetected infection. Additionally, the user can enter a deferred blood draw scenario. The website calculates the number of similar donors that need to be deferred to prevent one donor, with an undetectable infection, from progressing to retrieval surgery.

User entered information:

The website requires users to enter:

  • The virus that is to be modeled
  • The Critical Care Interval (Time between admission and blood draw)
  • The Jurisdiction in which the donor lives
  • The increased viral risk behavioral group

Modifiable Constants

The Visualiser tool has a number of default constants that can be modified.

These include:

  • Assay's X50 Limit of Detection (cp/ml)
    Assay's X95 Limit of Detection (cp/ml)
  • Viral Doubling Rate (days)
  • The minimum infective concentration (cp/mL)
  • Incidence Rate of new infections (100 PY)

Model Outputs

The Visualiser produces the following outputs

  • A graph of the probability of non-detection after exposure as a function of time prior to blood draw.
  • An estimation of the assay's un-adjusted window period.
  • An estimation of the adjusted window period given the entered Critical Care Interval
  • The estimated risk of non-detection using the Quarantine Adjusted Window Period Model
  • The odds of a non-detected infection.

Additionally, if a second alternative deferred blood draw scenario is entered:

  • The number needed to defer to prevent one undetected donor.

Help

The visualiser tool has a link to an instructional video that can assist users with its use.

The video can be viewed here: https://doi.org/10.26188/28310900

History

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