Transmission of West Nile virus from an organ donor to four transplant recipients

TitleTransmission of West Nile virus from an organ donor to four transplant recipients
Publication TypeJournal Article
Year of Publication2003
AuthorsIwamoto M, Jernigan DB, Guasch A, Trepka MJ, Blackmore CG, Hellinger WC, Pham SM, Zaki S, Lanciotti RS, Lance-Parker SE, DiazGranados CA, Winquist AG, Perlino CA, Wiersma S, Hillyer KL, Goodman JL, Marfin AA, Chamberland ME, Petersen LR
JournalN Engl J Med
Pagination2196 - 203
Date PublishedMay 29
ISSN1533-4406 (Electronic) 0028-4793 (Linking)
Accession Number12773646
Keywords*Blood-Borne Pathogens, *West Nile virus / immunology / isolation & purification, Adult, Aged, Antibodies, Viral / blood, Blood Donors, Blood Transfusion / *adverse effects, Fatal Outcome, Female, Heart Transplantation / adverse effects, Humans, Immunoglobulin M / blood, Kidney Transplantation / adverse effects, Liver Transplantation / adverse effects, Male, Middle Aged, Organ Transplantation / *adverse effects, Tissue Donors, Viremia / diagnosis / transmission, West Nile Fever / diagnosis / *transmission

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

URLinternal-pdf://Iwamoto - WNV through organ transplant-1756630016/Iwamoto - WNV through organ transplant.pdf
DOI10.1056/NEJMoa022987 348/22/2196 [pii]
Notify Library Reference ID724

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