Record number:
589
Adverse Occurrence type:
MPHO Type:
Alerting signals, symptoms, evidence of occurrence:
Donor: headache, hemiparesis, intracerebral hemorrhage. Recipients (varied by organ): abdominal pain, altered mental status, thrombocytopenia, elevated aminotransferase levels, coagulopathy, graft dysfunction, fever, leukopenia, diarrhea, peri-incisional rash, seizures, elevated protein in CSF, subdural fluid on MRI.
Demonstration of imputability or root cause:
Recipients: immunohistochemical staining, cell culture, and quantitative real-time RT-PCR in multiple tissues. Donors: no evidence of LCMV.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
References:
Suggest references:
High clinical suspicion of donor-derived disease leads to timely recognition and early intervention to treat solid organ transplant-transmitted lymphocytic choriomeningitis virus. Gagan Mathur et al. TID 19 APR 2017
Expert comments for publication:
It is not feasible to proactively screen donors, it should be on the differential diagnosis in solid organ transplant recipients who develop an encephalitis syndrome within 2-3 weeks of transplantation, particularly in donors who died of intracerebral hemorrhage. Archived donor tissue samples are important to help determine imputability given that archived blood specimens have often tested negative in other SOT transmission cases. LCMV was isolated by PCR and viral culture in archived aorta tissue from a SOT and tissue donor; while the implications for tissue transplantation are unclear it is important to promptly notify tissue banks when SOT recipients develop LCMV.