ORIGINAL RESEARCH article
Front. Immunol.
Sec. Alloimmunity and Transplantation
The species, distribution, resistance of donor-derived pathogens and their impact on solid organ transplant recipients
Yan-Man Zhou 1
Xian-Quan Cui 2
Peng Zhao 2
Zhi-Guo Peng 2
Ning Guo 2
Huai-Bin Sun 2
Sheng-Li Liu 2
1. Shandong Provincial Hospital, Jinan, China
2. Qilu Hospital, Shandong University, Jinan, China
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Abstract
Background: Donor-derived infections (DDIs) have become a significant cause of infection in organ transplant recipients. Elaborating on the species, distribution, and resistance of donor-derived pathogens (DDPs) holds important implications. Methods: A retrospective cohort study included 302 deceased donors and their corresponding 464 kidney transplant recipients and 175 liver transplant recipients. We detected DDPs in preservation fluid (PF) using both conventional culture and mNGS, and subsequently analyzed the incidence of DDIs after transplantation. Results: 89.4% (270/302) of donors had positive cultures. Predominant multidrug-resistant organism included HLAR-Enterococcus, CRAB, CRKP, CRPA, MRS and ESBL-Escherichia coli. Compared with conventional culture, mNGS exhibited superior sensitivity for detecting bacteria and fungus in PF, with shorter turnaround time ( p < 0.001). The incidences of DDIs in kidney and liver transplant recipients were 16.6% (77/464) and 19.4% (34/175) respectively. The recipients with DDIs were associated with elevated serum creatinine or total bilirubin levels, increased infection events, higher risks of graft loss, elevated mortality, and longer length of hospital stay (p < 0.05). Conclusions: Multidrug-resistant organism are prevalent in deceased donors, with PF contamination primarily originating from donors. Integration of mNGS into donor screening protocols enables timely antimicrobial intervention, potentially improving transplant outcomes.
Summary
Keywords
donor-derived infection, metagenomic next-generation sequencing, Multidrug-resistant organism, preservation fluid, solid organ transplantation
Received
01 January 2026
Accepted
20 February 2026
Copyright
© 2026 Zhou, Cui, Zhao, Peng, Guo, Sun and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Sheng-Li Liu
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