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Transmission of West Nile virus by organ transplantation
Author(s) -
Kusne Shimon,
Smilack Jerry
Publication year - 2005
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.20350
Subject(s) - medicine , virology , organ transplantation , viremia , organ donation , transplantation , nucleic acid test , virus , flaviviridae , immunology , transmission (telecommunications) , viral disease , blood transfusion , pathology , infectious disease (medical specialty) , disease , electrical engineering , engineering , covid-19
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. (N Engl J Med 2003;348:2196–2203).