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July 24/31, 2013

Donor-Derived Infections With Central Nervous System Pathogens After Solid Organ Transplantation

Author Affiliations
  • 1Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor
JAMA. 2013;310(4):378-379. doi:10.1001/jama.2013.7989

During the past decade, numerous instances have been reported of donor-derived infection among recipients of solid organ transplants with pathogens associated with central nervous system (CNS) infections.1-7 Many cases have received significant attention both among the transplant community and the lay media. Notable pathogens have included West Nile virus (WNV), Balamuthia mandrillaris, lymphocytic choriomeningitis virus, and rabies virus. In most cases, donor-derived infection was suspected only after symptoms developed in recipients and further testing of archived specimens identified a donor source. In some cases, lack of recipient exposure to the pathogen prompted investigation for donor origin of the infection. Recipient outcomes were often poor; in part because even after identification of infection, effective treatment was not available.