Donor-Derived Infection in Kidney Transplant Recipients
Article Sidebar
Main Article Content
Abstract
Donor-derived infections in kidney transplant recipients are a rare complication following kidney transplantation. However, when it occurs, it can slow down recovery, increase the duration of treatment, raise medical costs, decrease the patient’s quality of life, and may even be severe enough to lead to death. Diagnosing infections in donor kidney transplant recipients requires cooperation among multiple agencies, including the agency that treated the donor before death, the organ transplant center, and the receiving transplant unit. The diagnosis involves taking a medical history, conducting physical exams, and performing laboratory tests to detect transmissible infections post-transplant, such as human immunodeficiency virus, Hepatitis B virus, and Hepatitis C virus. This ensures that the donated organs will cause the least harm to the transplant recipient and contribute to better post-transplant outcomes.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
This article is published under CC BY-NC-ND 4.0 license, which allows for non-commercial reuse of the published paper as long as the published paper is fully attributed. Anyone can share (copy and redistribute) the material in any medium or format without having to ask permission from the author or the Nephrology Society of Thailand.
References
Wolfe CR, Ison MG. Donor-derived infections: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9):e13547. doi: 10.1111/ctr.13547
White SL, Rawlinson W, Boan P, Sheppeard V, Wong G, Waller K, et al. Infectious disease transmission in solid organ transplantation: Donor evaluation, recipient risk, and outcomes of transmission. Transplant Direct. 2019;5(1):e416. doi: 10.1097/TXD.0000000000000852.
Len O, Garzoni C, Lumbreras C, Molina I, Meije Y, Pahissa A, et al. Recommendations for screening of donor and recipient prior to solid organ transplantation and to minimize transmission of donor-derived infections. Clin Microbiol Infect. 2014;20 Suppl 7:10-8. doi: 10.1111/1469-0691.12557.
Neilan AM, Cohn J, Sacks E, Gandhi AR, Fassinou P, Walensky RP, et al. Evaluating point-of-care nucleic acid tests in adult human immunodeficiency virus diagnostic strategies: A Côte d’Ivoire modeling analysis. Open Forum Infect Dis. 2021;8(6):ofab225. doi: 10.1093/ofid/ofab225.
Fishman JA, Grossi PA. Donor-derived infection—the challenge for transplant safety. Nat Rev Nephrol. 2014;10(11):663-72. doi: 10.1038/nrneph.2014.159.
Sommerer C, Schröter I, Gruneberg K, Schindler D, Behnisch R, Morath C, et al. Incidences of infectious events in a renal transplant cohort of the German Center of Infectious Diseases (DZIF). Open Forum Infect Dis. 2022;9(7):ofac243. doi: 10.1093/ofid/ofac243.
Mo H, Lee J, Park JB, Park SC, Kim YH, Han A, et al. Kidney transplantation from deceased donors with bloodstream infection: A multicenter retrospective study. J Korean Med Sci. 2022;37(1):e4. doi: 10.3346/jkms.2022.37.e4.
Kumar D, Cattral MS, Robicsek A, Gaudreau C, Humar A. Outbreak of Pseudomonas aeruginosa by multiple organ transplantation from a common donor. Transplantation. 2003;75(7):1053-5. doi: 10.1097/01.TP.0000057532.36625.34.
Greenwald MA, Kuehnert MJ, Fishman JA. Infectious disease transmission during organ and tissue transplantation. Emerg Infect Dis. 2012;18(8):e1. doi: 10.3201/eid1808.120277.
Epperson K, Crane C, Ingulli E. Prevention, diagnosis, and management of donor-derived infections in pediatric kidney transplant recipients. Front Pediatr. 2023;11:1167069. doi: 10.3389/fped.2023.1167069.
Nambiar P, Silibovsky R, Belden KA. Infection in kidney transplantation. Contemporary Kidney Transplantation. 2018;307-27. doi: 10.1007/978-3-319-19617-6_22
Centers for Disease Control and Prevention. Guidelines for preventing transmission of human immunodeficiency virus through transplantation of human tissue and organs. MMWR Recomm Rep. 1994;43 (Rr-8):1-17.
Pereira MR, Dube GK, Tatem L, Burack D, Crew RJ, Cohen DJ, et al. HIV transmission through living donor kidney transplant: An 11-year follow-up on the recipient and donor. Transpl Infect Dis. 2021;23(4):e13691. doi: 10.1111/tid.13691.
Centers for Disease Control and Prevention. HIV transmitted from a living organ donor—New York City, 2009. MMWR Morb Mortal Wkly Rep. 2011;60(10):297–301.
Simonds RJ. HIV transmission by organ and tissue transplantation. AIDS. 1993;7 Suppl 2:S35-8. doi: 10.1097/00002030-199311002-00008.
Fearon M. The laboratory diagnosis of HIV infections. Can J Infect Dis Med Microbiol. 2005;16(1):26-30. doi: 10.1155/2005/515063.
Srisuwarn P, Sumethkul V. Kidney transplant from donors with hepatitis B: A challenging treatment option. World J Hepatol. 2021;13(8):853-67. doi: 10.4254/wjh.v13.i8.853.
Ouseph R, Eng M, Ravindra K, Brock GN, Buell JF, Marvin MR. Review of the use of hepatitis B core antibody-positive kidney donors. Transplant Rev (Orlando). 2010;24(4):167-71. doi: 10.1016/j.trre.2010.05.001.
Chancharoenthana W, Townamchai N, Pongpirul K, Kittiskulnam P, Leelahavanichkul A, Avihingsanon Y, et al. The outcomes of kidney transplantation in hepatitis B surface antigen (HBsAg)-negative recipients receiving grafts from HBsAg-positive donors: A retrospective, propensity score-matched study. Am J Transplant. 2014;14(12):2814-20. doi: 10.1111/ajt.12921.
Wachs ME, Amend WJ, Ascher NL, Bretan PN, Emond J, Lake JR, et al. The risk of transmission of hepatitis B from HBsAg(-), HBcAb(+), HBIgM(-) organ donors. Transplantation. 1995;59(2):230-4.
Fernández-Galindo DA, Galván-Ramírez MdlL, Andrade-Sierra J, González-Espinoza E, Evangelista-Carrillo LA, Mendoza-Cabrera S, et al. Occult hepatitis B in kidney transplant recipients and donors from Western Mexico. Int J Infect Dis. 2020;91:17-21. doi: 10.1016/j.ijid.2019.10.023.
Marinaki S, Kolovou K, Sakellariou S, Boletis JN, Delladetsima IK. Hepatitis B in renal transplant patients. World J Hepatol. 2017;9(25):1054-63. doi: 10.4254/wjh.v9.i25.1054.
Rawashdeh B, Hulse J, Agarwal A. Transplant of a kidney from a hepatitis C viremic donor to a naïve recipient without viral transmission: A case report. Am J Case Rep. 2021;22:e927532. doi: 10.12659/AJCR.927532.
Molnar MZ, Nair S, Cseprekal O, Yazawa M, Talwar M, Balaraman V, et al. Transplantation of kidneys from hepatitis C-infected donors to hepatitis C-negative recipients: Single center experience. Am J Transplant. 2019;19(11):3046-57. doi: 10.1111/ajt.15530.
Soza A, Riquelme A, Arrese M. Routes of transmission of hepatitis C virus. Ann Hepatol. 2010;9:S30-S3.
Natov SN, Pereira BJG. Management of hepatitis C infection in renal transplant recipients. Am J Transplant. 2002;2(6):483-90.
Latt NL. Update on the management of hepatitis C virus infection in the setting of chronic kidney disease and kidney transplantation. Gastroenterol Hepatol (N Y). 2018;14(12):687-705.
Yin S, Wu L, Liu C, Jia Z, Wu J, Zhang F, et al. Risk for donor-derived syphilis after kidney transplantation, China, 2007-2022. Emerg Infect Dis. 2024;30(7):1420-4. doi: 10.3201/eid3007.240009.
Cortes NJ, Afzali B, MacLean D, Goldsmith DJA, O’Sullivan H, Bingham J, et al. Transmission of syphilis by solid organ transplantation. Am J Transplant. 2006;6(10):2497-9. doi: 10.1111/j.1600-6143.2006.01461.x.
Theodoropoulos N, Jaramillo A, Penugonda S, Wasik C, Brooks K, Ladner DP, et al. Improving syphilis screening in deceased organ donors. Transplantation. 2015;99(2):438-43. doi: 10.1097/TP.0000000000000323.
Ballout A, Yombi JC, Hassoun Z, Goffin E, Kanaan N. Secondary syphilis after renal transplantation. NDT Plus. 2008;1(6):442-4. doi: 10.1093/ndtplus/sfn139.
Schachtner T, Reinke P. Pretransplant prophylactic rituximab to prevent Epstein-Barr virus (EBV) viremia in EBV-seronegative kidney transplant recipients from EBV-seropositive donors: Results of a pilot study. Transpl Infect Dis. 2016;18(6):881-8. doi: 10.1111/tid.12605.
Bamoulid J, Courivaud C, Coaquette A, Chalopin J-M, Gaiffe E, Saas P, Ducloux D. Subclinical Epstein-Barr virus viremia among adult renal transplant recipients: Incidence and consequences. Am J Transplant. 2013;13(3):656-62. doi: 10.1111/ajt.12009.
Potluri VS, Zhang S, Schaubel DE, Shaikhouni S, Blumberg EA, Nasta SD, et al. The Association of Epstein-Barr Virus Donor and Recipient Serostatus With Outcomes After Kidney Transplantation : A Retrospective Cohort Study. Ann Intern Med. 2025;178(2):157-66. doi: 10.7326/ANNALS-24-00165.
Alfieri C, Tanner J, Carpentier L, Perpete C, Savoie A, Paradis K, et al. Epstein-Barr virus transmission from a blood donor to an organ transplant recipient with recovery of the same virus strain from the recipient’s blood and oropharynx. Blood. 1996;87(2):812-7.
Le J, Durand CM, Agha I, Brennan DC. Epstein-Barr virus and renal transplantation. Transplant Rev (Orlando). 2017;31(1):55-60. doi: 10.1016/j.trre.2016.12.001.
Nijland ML, Kersten MJ, Pals ST, Bemelman FJ, Ten Berge IJ. Epstein-Barr virus-positive posttransplant lymphoproliferative disease after solid organ transplantation: Pathogenesis, clinical manifestations, diagnosis, and management. Transplant Direct. 2016;2(1):e48. doi: 10.1097/TXD.0000000000000557
