Donor-derived aspergillosis from use of a solid organ recipient as a multiorgan donor

Area of Science:

• Transplantation Medicine
• Infectious Diseases
• Pathology

Background:

• Increasing organ demand necessitates using extended criteria donors.
• Organ scarcity drives the acceptance of donors with less stringent criteria.

Observation:

• A cardiac graft recipient, who died 9 days post-transplant from presumed cerebral hemorrhage, was utilized as an organ donor.
• Post-mortem examination revealed invasive aspergillosis of the brain as the cause of death.

Findings:

• One kidney transplant recipient experienced graft loss due to Aspergillus fumigatus infection.
• Prompt antifungal therapy prevented disseminated aspergillosis in other recipients.

Implications:

• Organs from donors with unexplained causes of death should not be accepted.
• Thorough donor evaluation is critical to prevent infectious complications in recipients.