{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T17:34:37Z","timestamp":1793208877375,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The presence of multidrug\u2010resistant Gram\u2010negative (MDR\u2010GN) organisms in solid organ transplantation (SOT) donors raises concerns regarding transplant safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed and Scopus (2010\u20132025) for observational studies reporting donor\u2010derived infections (DDI) among SOT recipients from donors with MDR\u2010GN colonization or infection. A single\u2010arm meta\u2010analysis was performed. Subgroup analyses examined donor risk categories (high\u2010risk, low\u2010risk), organ types, pathogen groups, and donor culture sites. 90\u2010day mortality was estimated for recipients at risk of donor\u2010to\u2010recipient transmission based on presence of MDR\u2010GN DDI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve cohort studies with 457 recipients were included. The pooled attack rate of MDR\u2010GN DDI was 29% (95%CI: 11%\u201349%). DDI occurred in 40% (95%CI: 20%\u201362%) of high\u2010risk transplantations but was absent in low\u2010risk scenarios (0%, 95%CI: 0%\u20131%). Transmission was associated with graft\u2010relevant exposure, including preservation fluid positivity (58%, 95%CI: 23%\u201389%) and organ\u2010specific cultures. 90\u2010day mortality among recipients corresponding to donors with carriage of MDR\u2010GN pathogens was 14% (95%CI: 6%\u201330%). Higher 90\u2010day mortality was observed among recipients with evidence of MDR\u2010GN DDI (49%, 95%CI: 12%\u201387%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although transmission from MDR\u2010GN donors seems to increase the mortality of the recipients, it is highly context\u2010dependent and primarily driven by graft\u2010related anatomical exposure rather than MDR status alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70714","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:44:28Z","timestamp":1791985468000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of Donor\u2010Derived Infections From Organ Donors Colonized or Infected With Multidrug\u2010Resistant Gram\u2010Negative Bacteria: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"40","author":[{"given":"Themistoklis","family":"Paraskevas","sequence":"first","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, Faculty of Medicine University General Hospital of Patras, University of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christodoulos","family":"Chatzigrigoriadis","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Faculty of Medicine University General Hospital of Patras, University of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis D.","family":"Kostakis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine University General Hospital of Patras, University of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Karydis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine University General Hospital of Patras, University of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marios","family":"Papasotiriou","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, Faculty of Medicine University General Hospital of Patras, University of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros","family":"Ntrinias","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, Faculty of Medicine University General Hospital of Patras, University of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Maroulis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine University General Hospital of Patras, University of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markos","family":"Marangos","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Faculty of Medicine University General Hospital of Patras, University of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Papachristou","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Kidney Transplantation, Faculty of Medicine University General Hospital of Patras, University of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo Antonio","family":"Grossi","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit, Department of Medicine and Surgery University of Insubria, ASST Sette Laghi  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stelios F.","family":"Assimakopoulos","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Infectious Diseases, Faculty of Medicine University General Hospital of Patras, University of Patras  Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-016-0526-9"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2018.04.004"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12645"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000488"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13547"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13594"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12094"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12557"},{"key":"e_1_2_9_10_1","volume-title":"Guide to the Quality and Safety of Organs for Transplantation","author":"European Directorate for the Quality of Medicines & HealthCare (EDQM), Council of 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