{"id":650,"date":"2009-12-20T12:58:34","date_gmt":"2009-12-20T17:58:34","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=650"},"modified":"2015-06-04T15:26:02","modified_gmt":"2015-06-04T19:26:02","slug":"infections-from-transplant-donors-rare-but-inevitable","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/infections-from-transplant-donors-rare-but-inevitable\/2009\/12\/20\/","title":{"rendered":"Infections from Transplant Donors: Rare but Inevitable"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-thumbnail wp-image-651\" title=\"amoeba\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2009\/12\/amoeba-150x1501.jpg\" alt=\"amoeba\" width=\"150\" height=\"150\" \/>Two kidney transplant patients are critically ill due to <em>Balamuthia mandrillaris <\/em>encephalitis <a href=\"http:\/\/www.nytimes.com\/2009\/12\/19\/health\/19transplant.html?_r=1&amp;scp=3&amp;sq=transplant&amp;st=cse\" target=\"_blank\">they acquired from the organ donor<\/a>:<\/p>\n<blockquote><p>The same infection probably killed the organ donor, but it was not diagnosed; his doctors thought he had an autoimmune disease. Two other patients also received heart and liver transplants from the donor, but neither has become ill.<\/p><\/blockquote>\n<p>Infections due to free-living amoeba are extremely rare; those acquired from transplant even more so.<\/p>\n<p>Hence the lesson from these transplant-related cases is not that there&#8217;s a new threat to the health of transplant recipients.<\/p>\n<p>But it&#8217;s a reminder that the infection risk will never be zero. \u00a0We cannot test donors for every possible disease, and the shortage of available organs means that some donor-derived infections will inevitably continue.<\/p>\n<p>(These <a href=\"http:\/\/content.nejm.org\/cgi\/content\/abstract\/354\/21\/2235\" target=\"_blank\">LCMV cases<\/a> caused quite the stir around here a few years ago.)<\/p>\n<p>Organ transplantation remains one of the great miracles of medicine. \u00a0With the caveat that I don&#8217;t know further details about this donor&#8217;s case, it seems that a (small) risk of donor-derived infection is the price of doing business.<\/p>\n<p>(Edit:\u00a0 And now the <em>WSJ <\/em>has weighed in <a href=\"http:\/\/online.wsj.com\/article\/SB10001424052748703344704574609960519672346.html\" target=\"_blank\">here.<\/a> Focus is on those harmed by the infection, understandably, and the need to make the process safer &#8212; but the fact remains that transplant will never be 100% safe.)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Two kidney transplant patients are critically ill due to Balamuthia mandrillaris encephalitis they acquired from the organ donor: The same infection probably killed the organ donor, but it was not diagnosed; his doctors thought he had an autoimmune disease. Two other patients also received heart and liver transplants from the donor, but neither has become [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,8],"tags":[101,494,940],"class_list":["post-650","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-patient-care","tag-balamuthia-mandrillaris","tag-infection","tag-transplantation"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/650","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=650"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/650\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=650"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=650"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=650"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}