Successful multiple organ donation after donor brain death due to Actinomyces israelii meningitis

Abstract

The increasing gap between availability of solid organs for transplantation and the demand has led to the inclusion of donor organs that, according to current guidelines, may be discarded, some of them because of the possibility for transmission of infection to the recipients. We present the first report, to the best of our knowledge, of a case of a brain-dead donor with a localized and treated Actinomyces israelii central nervous system infection who, after a thorough evaluation, provided organs for successful transplant procedures in four recipients. There was no evidence of transmission of infection within a 6-month follow-up. Relative contraindications must be individualized in order to expand the number of real organ donors, emphasizing caution in rare causes for brain death in which patients should be thoroughly evaluated for possible donation.

Review of the impact of donor characteristics on pediatric heart transplant outcomes

“…Bacterial infections occurring in potential donors complicate the decision regarding suitability of a donor for pediatric heart transplantation. Donors with a variety of infections including any culture positivity and meningitis have been reported without significant impact on outcomes in adult heart transplantation . In pediatrics, only three proven or probable donor‐derived disease transmissions related to bacterial infections (all Staphylococcus species ) were reported in over 5000 pediatric donors in the United States, and there were no deaths attributed to these transmissions .…”