Coccidioidomycosis Transmission Through Organ Transplantation: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee. Issue 12 (29th July 2016)

• Record Type: Journal Article
• Authors: Kusne, S.; Taranto, S.; Covington, S.; Kaul, D. R.; Blumberg, E. A.; Wolfe, C.; Green, M.
• Is Part Of: American journal of transplantation. Volume 16:Issue 12(2016:Dec.)
• Page Start: 3562
• Page End: 3567
• Publication Date: 2016-07-29
• Subjects: clinical research/practice -- infectious disease -- antibiotic: antifungal -- complication: infectious -- donors and donation: donor‐derived infections -- infection and infectious agents -- fungal; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.13950
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : Donor‐derived coccidioidomycosis has caused unexpected morbidity and mortality in transplant recipients. All proven or probable reports of donor‐derived coccidioidomycosis to the Disease Transmission Advisory Committee between 2005 and August 2012 were reviewed. Six reports of proven or probable coccidioidomycosis were discovered. In four of six, the infection was first detected at autopsy in the recipient. In two cases it was first identified in the donor. Twenty‐one recipients received organs from these six donors. Transmission occurred in 43% at a median of 30 days posttransplant with a mortality rate of 28.5%. Eleven recipients received preemptive antifungals, seven did not receive treatment, and treatment information was not reported for three recipients. Five of seven who did not receive prophylaxis/treatment died and all 11 who received early therapy survived. Six deaths occurred 14 to 55 days after transplant, with a median of 21 days. For exposed recipients, donor‐derived coccidioidomycosis is a significant cause of morbidity and mortality. Evidence of infection in one recipient should prompt immediate evaluation for treatment of all other recipients from the same donor as preemptive treatment was effective. Further studies are needed to decide whether all donors from endemic areas should have routine serologic screening. Abstract : This article reviews Disease Transmission Advisory Committee (DTAC) coccidioidomycosis donor‐derived cases after organ transplantation (Jan 2005–Aug 2012), and finds high mortality, consistent with the existing literature.