Transmission of West Nile Virus from an Organ Donor to Four Transplant Recipients
| Autor: | Susan E. Lance-Parker, Mary E. Chamberland, Andrea G Winquist, Walter C. Hellinger, Carlos A. DiazGranados, Jesse L. Goodman, Si M. Pham, Martha Iwamoto, Daniel B. Jernigan, Carl A Perlino, Carina Blackmore, Mary Jo Trepka, Steven T. Wiersma, Anthony A. Marfin, Krista L Hillyer, Robert S. Lanciotti, Lyle R. Petersen, Sherif R. Zaki, Antonio Guasch |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty viruses Blood Donors Antibodies Viral Organ transplantation Central nervous system disease Fatal Outcome Blood-Borne Pathogens Humans Medicine Viremia Aged biology business.industry Transmission (medicine) Transfusion Reaction virus diseases Organ Transplantation General Medicine Middle Aged medicine.disease Kidney Transplantation Virology Tissue Donors Liver Transplantation Transplantation Immunoglobulin M biology.protein Heart Transplantation Female Viral disease Antibody Complication business West Nile virus West Nile Fever Encephalitis |
| Zdroj: | New England Journal of Medicine. 348:2196-2203 |
| ISSN: | 1533-4406 0028-4793 |
| Popis: | In August 2002, fever and mental-status changes developed in recipients of organs from a common donor. Transmission of West Nile virus through organ transplantation was suspected.We reviewed medical records, conducted interviews, and collected blood and tissue samples for testing with a variety of assays. Persons who donated blood to the organ donor and associated blood components were identified and tested for West Nile virus.We identified West Nile virus infection in the organ donor and in all four organ recipients. Encephalitis developed in three of the organ recipients, and febrile illness developed in one. Three recipients became seropositive for West Nile virus IgM antibody; the fourth recipient had brain tissue that was positive for West Nile virus by isolation and nucleic acid and antigen assays. Serum specimens obtained from the organ donor before and immediately after blood transfusions showed no evidence of West Nile virus; however, serum and plasma samples obtained at the time of organ recovery were positive on viral nucleic acid testing and viral culture. The organ donor had received blood transfusions from 63 donors. A review of blood donors and follow-up testing identified one donor who had viremia at the time of donation and who became seropositive for West Nile virus IgM antibodies during the next two months.Our investigation of this cluster documents the transmission of West Nile virus by organ transplantation. Organ recipients receiving immunosuppressive drugs may be at high risk for severe disease after West Nile virus infection. Blood transfusion was the probable source of the West Nile virus viremia in the organ donor. |
| Databáze: | OpenAIRE |
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