Transmission of West Nile virus from an organ donor to four transplant recipients
Transmission of West Nile virus from an organ donor to four transplant recipients
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DOI：
10.1056/nejmoa022987
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发表时间：
2003-05-29
影响因子：
158.5
通讯作者：
Withum, D
中科院分区：
文献类型：
--
作者：
Iwamoto, M;Jernigan, DB;Withum, D
背景：2002年8月，一位普通捐献者的器官接受者出现发热和精神状态变化。西尼罗河病毒通过器官transplantation.METHODS传播被怀疑：我们回顾了医疗记录，进行了访谈，并收集了血液和组织样本进行测试与各种分析。捐献血液的器官捐献者和相关的血液成分的人进行了鉴定和测试西尼罗河病毒。结果：我们确定了西尼罗河病毒感染的器官捐献者和所有四个器官接受者。三名器官接受者出现脑炎，一名出现发热性疾病。三个收件人成为血清阳性西尼罗河病毒IgM抗体;第四收件人的脑组织是阳性西尼罗河病毒的分离和核酸和抗原检测。在输血前和输血后立即从器官供体中获得的血清标本未显示西尼罗河病毒的证据;然而，在器官回收时获得的血清和血浆样本在病毒核酸检测和病毒培养上呈阳性。这位器官捐献者接受了63名捐献者的输血。献血者和后续检测的审查确定了一个捐助者谁在捐赠时有病毒血症，谁成为血清阳性西尼罗河病毒IgM抗体在接下来的两个months.CONCLUSIONS：我们的调查这一集群文件的西尼罗河病毒的传播器官移植。接受免疫抑制药物的器官接受者在感染西尼罗河病毒后可能有患严重疾病的高风险。输血是器官捐献者中西尼罗河病毒血症的可能来源。
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.