Transmission of Syphilis by Solid Organ Transplantation

Abstract

Two organ recipients developed serologic evidence of syphilis infection after renal transplantation from a common deceased donor with a history of treated syphilis. Testing of donor serum for syphilis, which occurred after transplantation, gave results interpreted as consistent with past infection. However, subsequent serologic results in the recipients suggested transmission of infection at transplantation due to active infection of the donor. This may be explained by recent donor re-infection in view of the current syphilis epidemic in the United Kingdom. An initial error in the treatment of recipients further served to highlight unfamiliarity in managing this resurgent infection in the context of organ transplantation.

Evaluation of Elecsys Syphilis Assay for Routine and Blood Screening and Detection of Early Infection

“…pallidum (1). It can also be transmitted from mother to child in utero or during birth or, rarely, by transfusion of blood, blood components, or organs from donors with active syphilis (1–5). The disease can be divided into stages, based on clinical findings.…”

Nonspecific Immunoglobulin Replacement in Lung Transplantation Recipients With Hypogammaglobulinemia

“…1 Syphilis has rarely been transmitted via organ transplantation, with one confirmed transmission reported to the Organ Procurement and Transplantation Network (OPTN) between 2005 and 2009 and two cases in the published literature. [2][3][4][5] There are also cases of transplantation of syphilis-positive organs where there was no transmission to the recipients after appropriate therapy. [6][7][8][9] Current policy requires that all deceased organ donors be screened for syphilis infection using a Food and Drug Administration (FDA)-cleared screening or diagnostic test (Table S1, SDC, http://links.lww.com/TP/B28).…”

Syphilis-specific Immunoglobulin G Seroconversion After Double-lung Transplantation

“…6 -8 Cortes et al described 2 cases of kidney transplantation with findings similar to ours. 3 The organ donor had a TPHA of 1:1280 and an RPR of 1:2. The kidney transplant recipients were initially treated with a single dose of 2.4 g intravenous penicillin and, after showing positive syphilis serology at follow-up, intramuscular treponemidical therapy was started.…”

“…2 To the best of our knowledge, only one report of syphilis transmission by solidorgan transplantation in 2 renal transplant recipients has been documented. 3 A latent or past syphilis infection is not a contraindication to organ donation if a prophylactic antibiotic treatment is administered to recipients in the post-transplant phase. 4 We report here the case of a lung transplant recipient with seroconversion in anti-T pallidum IgG antibody tests after transplantation.…”