To summarize the preliminary experience of solid organ donation from donors complicated with systemic infection after citizens' death.

Clinical data of 47 donors after cardiac death admitted to Wengyuan County People's Hospital from January 2015 to May 2019 were retrospectively analyzed. The informed consents of all donors and recipients and/or family members were obtained and the local ethical committee approval was received. Among them, 38 patients were male and 9 female, aged (29±14) years on average. The results of bacterial culture from the donor peripheral venous blood (PVB), blood from central venous catheter (BCVC), tip of central venous catheter (TCVC), bronchial lavage fluid and urine were analyzed.

The length of ICU stay for 47 donors was 1-35 d with a median of 10 d. The positive rates of bacterial culture from PVB, BCVC, TCVC, bronchial aspirate and urine of donors were 6%(3/47), 4%(2/47), 6%(3/47), 17%(8/47) and 4%(2/47), respectively. For donors with positive PVB, gram-positive bacterial infection was observed in 1 case and gram-negative in 2 cases and Candida was isolated from 1 case. Candida was isolated from 3 donors and Escherichia coli was isolated from 2 donors through the urine samples. Recipients undergoing liver transplantation received antibiotic treatments according to drug sensitivity test of bacteria in PVB, whereas kidney transplantation recipients received antibiotic treatments according to drug sensitivity test of bacteria in PVB and urine samples. Other negative recipients were treated with empirical medication. A total of 47 livers and 94 kidneys were obtained and successfully applied in 44 cases of liver transplantation and 92 cases of kidney transplantation. No bacterial infection occurred in the recipients.

For donors with positive results of bacterial culture test, prophylactic use of antibiotics can contribute to the success of liver and kidney transplantation. Donors with systemic infection is probably not a contraindication for organ transplantation.