Transmission of dengue virus from deceased donors to solid organ transplant recipients: case report and literature review

Abstract

Dengue fever is a vector-transmitted viral infection. Non-vectorial forms of transmission can occur through organ transplantation. We reviewed medical records of donors and recipients with suspected dengue in the first post-transplant week. We used serologic and molecular analysis to confirm the infection. Herein, we describe four cases of dengue virus transmission through solid organ transplantation. The recipients had positive serology and RT-PCR. Infection in donors was detected through serology. All cases presented with fever within the first week after transplantation. There were no fatal cases. After these cases, we implemented dengue screening with NS1 antigen detection in donors during dengue outbreaks, and no new cases were detected. In the literature review, additional cases had been published through August 2017. Transmission of Dengue virus can occur through organ donation. In endemic regions, it is important to suspect and screen for dengue in febrile and thrombocytopenic recipients in the postoperative period.

Chikungunya in solid organ transplant recipients, a case series and literature review

“…However, in our case series none of the SOT recipients developed severe complications as a result of CHIKV infection despite the presence of some of these risk factors. Additionally, none of the patients developed graft rejection, which is consistent with the reports in the literature that do not show any fatal or complicated cases, suggesting a more benign course of the infection …”

“…Additionally, none of the patients developed graft rejection, which is consistent with the reports in the literature that do not show any fatal or complicated cases, suggesting a more benign course of the infection. 14,19,21,26,27 Kee et al 15…”

ISHLT consensus statement on donor organ acceptability and management in pediatric heart transplantation

“…However, the risk is significantly reduced when both serology and nucleic acid testing are negative. 38,39 Dengue virus has been transmitted to recipients causing clinical illness post-transplant without deaths, 40 but transmission of West Nile Virus from donor to recipients has been reported to cause neuroinvasive disease in up to 70% of recipients and death in 30%. 41 DDI has not yet been reported with Zika virus.…”

Emergent Arboviruses and Renal Transplantation: A Global Challenge

“…Although some reports highlight a relatively benign course of the disease in transplant patients, not unlike the healthy population,29, 30, 31, 32 other reports present a more severe clinical scenario 16, 33, 34, 35. There are no reports of graft rejection among dengue-infected cases 36 …”

“…Therefore, because the intensity of immunosuppression does not determine the outcome of most patients, and because there is no specific therapy for dengue infection in transplant recipients, early diagnosis and supportive treatment are currently available tools for better clinical management 36, 41…”