Bitten by an Organ Transplant?

Rabies transmitted via transplanted kidney in rare case

(RxWiki News) Kidney transplants can save lives. But sometimes, transplant recipients are faced with unexpected complications, like getting an illness from the transplanted kidney. Fortunately, such complications are rare and can be prevented.

In an unusual case in 2013, a patient died of rabies 18 months after receiving a kidney transplant. The rabies virus was transmitted to the patient via the transplant.

According to the study, this type of transmission is extremely rare, and there have only been two other such cases of rabies spreading through solid organ transplants reported.

"Follow up regularly with your doctor after an organ transplant."

This study was conducted by Neil M. Vora, MD, of the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, and colleagues.

The aim of this study was to determine if a patient who died 18 months after a kidney transplant was exposed to rabies via the transplanted kidney received from a deceased person.

Rabies is a deadly disease caused by a virus, and patients infected with rabies usually develop an inflammation of the brain called encephalitis. The disease is rare in the US and approximately 2 people die each year of rabies. Between the years 2000 and 2010, all rabies cases in the US, except two, were the result of contact with bats.

In this particular study, the organ recipient patient who died after showing rabies-like symptoms did not report any exposure to rabid animals.

The researchers found that prior to death, the kidney donor had rabies symptoms including fever, seizures and difficulty swallowing. These symptoms were then thought to be due to food poisoning.

Rabies virus was detected in a brain tissue sample taken from the donor. The source of the virus was found to be a raccoon.

The virus that infected the donor brain tissue was found to be the same type of virus that infected the kidney transplant recipient, suggesting that rabies was transmitted via the organ transplant.

The researchers also looked at three other patients who had received organs (right kidney, heart and liver) from the same organ donor. They did not have any signs and symptoms of rabies. They received a vaccine to prevent rabies.

The authors concluded that a standard evaluation of potential organ donors who show signs of brain inflammation could be considered in the future. They also suggested that the risks and benefits of receiving such a transplant be evaluated.

“This transmission event provides an opportunity for enhancing rabies awareness and recognition and highlights the need for a modified approach to organ donor screening and recipient monitoring for infectious encephalitis. This investigation also underscores the importance of collaboration between clinicians, epidemiologists, and laboratory scientists,” the study authors wrote.

This study was published July 23 in the Journal of the American Medical Association (JAMA).

The study received funding from the CDC, Maryland Department of Health and Mental Hygiene, North Carolina Division of Public Health and Florida Department of Health. No potential conflicts of interest were reported.

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Review Date: 
July 23, 2013