Regarding unexpected severe and life-threatening donor-transmitted viral infections and use of high-risk behavior donors
✍ Scribed by Shimon Kusne
- Publisher
- John Wiley and Sons
- Year
- 2008
- Tongue
- English
- Weight
- 73 KB
- Volume
- 14
- Category
- Article
- ISSN
- 1527-6465
- DOI
- 10.1002/lt.21633
No coin nor oath required. For personal study only.
✦ Synopsis
In this issue, Ahm and Cohen 1 report on a 66-year-old liver transplant recipient who received a liver transplant in January 2007. The donor was a 39-year-old male, deceased after a head trauma, with a history of sex with men. His hepatitis C virus (HCV) and human immunodeficiency virus (HIV) serology before and after blood transfusion were negative. The donor heart and kidneys were accepted by other medical centers in the Chicago area. In November 2007, the hospital was notified by the local Organ Procurement Organization (OPO) that the donor was found to be both HIV-positive and HCV-positive. Apparently, the other recipients of the same donor at the other institutions were tested positive by nucleic acid amplification test (NAT) for HIV and HCV. At that point the liver transplant recipient was retested and was found to be positive for both of these viruses. The patient was placed on antiretroviral medications but later on developed urosepsis, cytomegalovirus viremia, and renal failure, and expired at the end of January 2008. This report is alarming because it brings up the question of organ transplantation safety.
Donor-transmitted infections have been reported in the literature before, including bacterial, fungal, viral, and protozoal infections. Gottesdiener 2 reviewed these infections in detail in 1989 and among the viral infections transmitted by transplantation, he also described HIV in solid organ and bone marrow transplantation, rabies in corneal transplantation, and Creutzfeldt-Ja-kob Disease in dural matter and cornea transplant recipients. The eligibility criteria for deceased donor organ donation was defined and approved by the Association of Organ Procurement Organizations. 3 Over the last decade, severe and unexpected life-threatening donor-transmitted viral infections after solid organ transplantation have been reported, as follows.