Successful solid organ transplantation from septicemic cadaveric donors: case report

Area of Science:

• Transplantation immunology
• Infectious diseases in organ donation
• Microbiology in transplantation

Background:

• Systemic donor infections, particularly gram-negative bacteremia, traditionally contraindicate cadaveric organ donation due to transmission risks to immunosuppressed recipients.
• The critical shortage of transplantable organs necessitates re-evaluation of donor criteria, including the use of organs from infected donors.

Observation:

• Two cases of organ donation from bacteremic donors (Klebsiella and Acinetobacter baumannii) were analyzed.
• Donors received 48 hours of appropriate antibiotic therapy, resulting in negative blood cultures before organ procurement.
• Recipients received culture-specific antibiotics for 10 days post-transplantation; one donor's heart and corneas were excluded due to infection.

Findings:

• All 44 solid organs transplanted from the two donors were successfully utilized.
• Recipients demonstrated excellent graft function at a median of 90 days post-transplantation.
• No transmission of infection from donor to recipient was observed.

Implications:

• Bacteremic donors with severe sepsis, when treated appropriately, can be considered for organ transplantation.
• This approach may help alleviate organ shortages while maintaining patient safety and graft viability.
• Further research into donor infection management protocols can expand the donor pool for life-saving transplants.