Outbreak Investigations

Transplant Safety: Recognizing Donor-Derived InfectionsExternalExternal

Estimates of Infection

Transplant transmitted infections are very rare. They are suspected in about 1 % of transplants and confirmed in far fewer (Ison, et al).

Pertinent Published Reports of CDC-Investigated Infectious Diseases Transmitted through Transplantation – United States (2000 – 2018)
Virus Transmissions
  • CDC. Public Health Dispatch: West Nile Virus Infection in Organ Donor and Transplant Recipients — Georgia and Florida, 2002. MMWR Morb Mortal Wkly Rep. 2002. 51(35):790.
  • CDC. Update: Investigation of West Nile Virus infections in recipients of organ transplantation and blood transfusion – Michigan, 2002. MMWR Morb Mortal Wkly Rep. 2002. 51(39):879.
  • CDC. Hepatitis C Virus Transmission from an Antibody-Negative Organ and Tissue Donor — United States, 2000–2002. MMWR Morb Mortal Wkly Rep. 2003. 52(13):273-276.
  • Srinivasan, A., et al., Transmission of rabies virus from an organ donor to four transplant recipients. N Engl J Med, 2005. 352(11):1103-11.
  • CDC. West Nile Virus Infections in Organ Transplant Recipients — New York and Pennsylvania, August–September, 2005. MMWR Morb Mortal Wkly Rep. 2005. 54(40):1021-1023.
  • Fischer, S.A., et al., Transmission of lymphocytic choriomeningitis virus by organ transplantation. N Engl J Med, 2006. 354(21):2235-49.CDC.
  • CDC. Brief Report: Lymphocytic Choriomeningitis Virus Transmitted Through Solid Organ Transplantation — Massachusetts, 2008. MMWR Morb Mortal Wkly Rep. 2008. 57(29):799-801.
  • CDC. West Nile Virus Transmission via Organ Transplantation and Blood Transfusion — Louisiana, 2008. MMWR Morb Mortal Wkly Rep. 2009. 58(45):1263-1267.
  • Ison, M.G., Llata, E, Conover, C S, et al., Transmission of human immunodeficiency virus and hepatitis C from an organ donor to four transplant recipients. Am J Transplant, 2011. 11(6):1218-1225.
  • CDC. HIV Transmitted from a Living Organ Donor — New York City, 2009. MMWR Morb Mortal Wkly Rep. 2011. 60(10):297-301.
  • CDC. Notes from the Field: Transplant-Transmitted Hepatitis B Virus – United States, 2010. MMWR Morb Mortal Wkly Rep. 2011. 60(32):1087.
  • CDC. Potential Transmission of Viral Hepatitis through Use of Stored Vessels as Conduits in Organ Transplantation – Pennsylvania, 2009. MMWR Morb Mortal Wkly Rep. 2011:60(6):172-174.
  • CDC. Transmission of hepatitis C virus through transplanted organs and tissue—Kentucky and Massachusetts, 2011 [published erratum appears in MMWR Morb Mortal Wkly Rep 2012;61(4):80]. MMWR Morb Mortal Wkly Rep 2011;60(50):1697-700.
  • Ison MG, et al. Transmission of human immunodeficiency virus and hepatitis C virus from an organ donor to four transplant recipients. Am J Transplant. 2011 Jun;11(6):1218-25.
  • MacNeil, A., et al. Solid organ transplant-associated lymphocytic choriomeningitis, United States, 2011, Emerging Infectious Diseases, 2012. 18(8):1256-1262.
  • Fischer SA, et al. Transmission of lymphocytic choriomeningitis virus by organ transplantation. N Engl J Med. 2006;354:2235–49.
  • Srinivasan A, et al. Transmission of rabies virus from an organ donor to four transplant recipients. NEJM. 2005;352:1103–11.
  • CDC. Lymphocytic choriomeningitis virus infection in organ transplant recipients—Massachusetts, Rhode Island, 2005. MMWR Morb Mortal Wkly Rep. 2005;54:537–9.
  • CDC. West Nile virus infections in organ transplant recipients—New York and Pennsylvania, August–September, 2005. MMWR Morb Mortal Wkly Rep.2005;54:1021–3.
  • CDC. Brief report: lymphocytic choriomeningitis virus transmitted through solid organ transplantation- Massachusetts, 2008. MMWR Morb Mortal Wkly Rep. 2008;57:799–801.
  • CDC. West Nile virus transmission via organ transplantation and blood transfusion—Louisiana, 2008. MMWR Morb Mortal Wkly Rep. 2009;58:1263–7.
  • Macneil A, et al. Solid organ transplant-associated lymphocytic choriomeningitis, United States, 2011. Emerg Infect Dis. 2012 Aug;18(8):1256-62.
  • Vora NM, et al. Raccoon rabies virus variant transmission through solid organ transplantation. 2013 Jul 24; 310(4):398-407.
  • Blau DM, et al. West Nile virus RNA in tissues from donor associated with transmission to organ transplant recipients. Emerg Infect Dis. 2013;19(9):1518-20.
  • Suryaprasad A, et al. Transmission of Hepatitis C Virus From Organ Donors Despite Nucleic Acid Test Screening. Am J Transplant. 2015 Jul;15(7):1827-35.
  • Dollard SC, et al. Donor-derived Kaposi’s sarcoma in a liver-kidney transplant recipient. Am J Transplant. 2018 Feb;18(2):510-513.
  • Foster MA, et al. Transmission of Hepatitis A Virus through Combined Liver-Small Intestine-Pancreas Transplantation. Emerg Infect Dis. 2017 Apr;23(4):590-596.
  • Puch SM, et al. Transmission of Eastern Equine Encephalitis Virus from an Organ Donor to Three Transplant Recipients. Clinical Infectious Disease. 2018 Oct 29 (epub ahead of print).
CDC Expert Commentary
Susan N. Hocevar, MD

Transplant Safety: Recognizing Donor-Derived InfectionsExternal
Microsporidiosis is an emerging transplant-associated infection, and CDC depends on astute clinicians to recognize the signs of this and other donor-derived diseases. February 2014.

Bacteria Transmissions
  • CDC. Septic Arthritis Following Anterior Cruciate Ligament Reconstruction Using Tendon Allografts — Florida and Louisiana, 2000. MMWR Morb Mortal Wkly Rep. 2001. 50(48): p. 1081-1083.
  • CDC. Update: Allograft-Associated Bacterial Infections — United States, 2002. MMWR, 2002. 51(10): p. 207-210.
  • CDC. Clostridial Endophthalmitis after Cornea Transplantation — Florida, 2003. MMWR Morb Mortal Wkly Rep. 2003. 52(48): p. 1176-1179.
  • CDC. Invasive Streptococcus pyogenes After Allograft Implantation — Colorado, 2003. MMWR Morb Mortal Wkly Rep. 2003. 52(48): p. 1173-1176.
  • Winthrop, K.L., et al., Transmission of mycobacterium tuberculosis via lung transplantation. Am J Transplant, 2004. 4(9): p. 1529-33.
  • Kainer, M.A., et al.. Clostridium infections associated with musculoskeletal-tissue allografts. N Engl J Med, 2004. 350(25): p. 2564-71.
  • CDC. Transplantation-Transmitted Tuberculosis — Oklahoma and Texas, 2007. MMWR, 2007. 57(13): p. 333-336.
  • CDC. Transmission of Multidrug-Resistant Escherichia coli through Kidney Transplantation – California and Texas, 2009. MMWR Morb Mortal Wkly Rep. 2010. 59(50): p. 1642-1646.
  • Cartwright, E.J., et al., Transmission of Elizabethkingia meningoseptica (formerly Chryseobacterium meningosepticum) to tissue-allograft recipients: a report of two cases. J Bone Joint Surg Am, 2010. 92(6): p. 1501-6.
  • Kay A, et al. Solid Organ Transplant-Transmitted Tuberculosis Linked to a Community Outbreak – California, 2015..Am J Transplant. 2017 Oct;17(10):2733-2736.
  • Novosad SAet al. Mycoplasma hominis Infections Transmitted Through Amniotic Tissue Product. Clin Infect Dis. 2017 Oct 1;65(7):1152-1158.
  • Wendt JM, et al. Transmission of methicillin-resistant Staphylococcus aureus infection through solid organ transplantation: confirmation via whole genome sequencing. Am J Transplant. 2014 Nov; 14(11):2633-9.
Fungus Transmissions
  • Alexander, B.D., et al., Fatal Apophysomyces elegans infection transmitted by deceased donor renal allografts. Am J Transplant, 2010. 10(9): p. 2161-7.
  • Engelthaler, D.M., et al. Next-generation sequencing of Coccidioides immitis isolated during cluster investigation. Emerg Infect Dis, 2011. 17(2): p. 227-32.
  • Baddley, J.W., et al. Transmission of Cryptococcus neoformans by Organ Transplantation. Clin Infect Dis, 2011. 52(4): p. e94-8.
  • Hocevar SN, et al. Microsporidiosis acquired through solid organ transplantation: a public health investigation. Ann Intern Med. 2014.
  • Smith RM, et al. Three Cases of Neurologic Syndrome Caused by Donor-Derived Microsporidiosis. Emerg Infect Dis. 2017 Mar;23(3):387-395.
Parasite Transmissions
  • CDC. Chagas Disease after Organ Transplantation – United States, 2001. MMWR, 2002. 51(10): p. 210-212.
  • CDC. Chagas Disease after Organ Transplantation – Los Angeles, California, 2006. MMWR, 2006. 55(29): p. 798-800.
  • Kun, H, et al. Transmission of Trypanosoma cruzi by heart transplantation, Clin Infect Dis, 2009. 48:1534-40.
  • CDC. Balamuthia mandrillaris Transmitted through Organ Transplantation – Mississippi, 2009. MMWR, 2010. 59(36):1165-1170.
  • CDC. Notes from the Field: Transplant-Transmitted Balamuthia mandrillaris — Arizona, 2010. MMWR, 2010. 59(36):1182.
  • CDC. Transmission of Strongyloides stercoralis through transplantation of solid organs – Pennsylvania, 2012.  MMWR, 2013. 62(14);264-266.
  • Abanyie FA, et al., Donor-Derived Strongyloides stercoralis Infection in Solid Organ Transplant Recipients in the United States, 2009-2013 Am J Transplant. 2015: 15(5):1369–75.
  • Farnon EC, et al. Transmission of Balamuthia mandrillaris by Organ Transplantation. Clin Infect Dis. 2016 Oct 1;63(7):878-888.
  • Abanyie FA, et al. Organ Donor Screening Practices for Strongyloides stercoralis Infection among US Organ Procurement Organizations. Transplant Infectious Disease. 2018: 20(3): e12865.
  • Gray EB, et al. Reactivation of Chagas disease among heart transplant recipients in the United States, 2012‐2016. Transpl Infect Dis. 2018;e12996. https://doi.org/10.1111/tid.12996.
Other Publications
Reference:

Ison MG, Hager J, Blumberg E, Burdick J, Carney K, Cutler J, et al. Donor-derived disease transmission events in the United States: data reviewed by the OPTN/UNOS Disease Transmission Advisory Committee. Am J Transplant. 2009;9:1929–35 10.1111/j.1600-6143.2009.02700.x