A patient has died following transplantation with a rabies-infected kidney. Three other patients who received organs from the same donor are being treated to prevent the deadly infection.
Because the donor was not suspected to have contracted rabies, his organs were not tested for the virus before his heart, liver, and kidneys were removed, said The New York Times. The deceased patient’s identifying information has not been released.
In 2004, transplanted organs were also responsible for having spread rabies, according to Dr. Matthew J. Kuehnert, the U.S. Centers for Disease Control and Prevention’s (CDC) director of the Office of Blood, Organ, and Other Tissue Safety, said The Times. In the 2004 case, four people who had been transplanted with organs from the same donor died.
Although infections from transplanted organs are considered rare, according to the Organ Procurement and Transplantation Network, infections can be fatal as drugs taken by donor recipients to prevent organ rejection leave patients vulnerable to infection due to the drugs’ immune suppressing properties, The Times explained.
Today, testing is conducted for HIV, hepatitis, and some other diseases, but is not possible for every infection, given that organ donations are scarce and organs deteriorate rapidly, The Times pointed out. This case, in particular, raises questions regarding whether to use the organs of donors who die of questionable neurological disorders; the number of patients that comprises is difficult to secure, said Dr. Kuehnert. For example, people believed to have died from stroke or other non-contagious brain disorders have been later diagnosed as having died from transmittal infections that include rabies, amoebic infections, and West Nile virus. West Nile virus is now among the illnesses for which organs slated for transplant are screened, The Times noted.
In this recent case, the donor died in 2011 in Florida. His organs went to patients in Florida, Georgia, Illinois, and Maryland. It took over one year for the patient who died to become ill with rabies, which has a particularly long incubation period, said The Times. The rabies strain involved is found in raccoons and the recipient had no known exposure to animals. Because of this, his physicians considered the transplanted organ as a possible disease source. Donor tissue samples—which had been stored—tested positive for the exact rabies strain that killed the recipient, said The Times.
The other three recipients have been contacted and given the rabies vaccine and immunoglobulins; none have fallen ill. The CDC is working to track down those who had been in contact with the donor and recipients and who might need treatment, as well, said The Times.
We previously wrote—prior to implementation of current HIV transplant testing protocols—about the transplant of an HIV-infected kidney. That case led to the CDC recommending that HIV tests be conducted on live donors within one week prior to surgery. In that case, a New York City patient became infected with the AIDs virus following a kidney transplant, making that defective surgery the first confirmed case in the U.S. in about 20 years. At that time, there was no strict policy in place for AIDs testing of live transplant donors.
Another case in the U.S. involved a Florida woman who filed a lawsuit in 2010 alleging she was infected with HIV from a 2007 kidney transplant. Another case was reported in 1989 in Italy.