Status:
Ready to upload
Record number:
1337
Adverse Occurrence type:
MPHO Type:
Time to detection:
1 month
Alerting signals, symptoms, evidence of occurrence:
The recipient tested syphilis-negative pre-transplant but at one month post-op an IgM syphilis antibody was detected; at 2 months the IgM antibody was not detectable but the TPPA was positive at 1:320 and VDRL was negative. At 6 months the TPPA titer had declined and IgG antibody remained present. This patient was treated with doxycycline and no evidence of syphilis disease was found, simply serologic seroconversion. The presence of IgG antibody for over 6 months and the transient post-operative appearance of IgM antibody suggests true asymptomatic infection rather than passive transfer of donor antibody to the recipient from the liver.
Demonstration of imputability or root cause:
Probable transmission of asymptomatic syphilis infection. The high titered syphilis antibody without clinically-apparent syphilis, suggests asymptomaic syphylis infection in the donor. Recipient's serology supports a diagnosis of asymptomatic infection. The evidence suggests that the donor transmitted the infection but no clinical disease developed, simply asymptomatic seroconversion.
Imputability grade:
2 Probable
Groups audience:
Keywords:
References:
Reference attachment:
Suggest references:
Tariciotti L, Das I, Dori L, Perera MT, Bramhall SR Asymptomatic transmission of Treponema pallidum (syphilis) through deceased donor liver transplantation. Transpl Infect Dis. 2012 Jun;14(3):321-5.