Infections transmitted by transplantation

Infections are frequently transmitted through solid-organ and, to a lesser extent, stem cell transplantation. There are 2 major types of donor-derived infections that are transmitted: those that would be expected secondary to donor and recipient screening (ie, transmission of cytomegalovirus, Epstein-Barr virus, or toxoplasmosis from a seropositive donor to a seronegative recipient) and those that are unexpected despite routine donor screening (ie, human immunodeficiency virus and hepatitis C virus transmitted from a seronegative donor). Expected transmissions occur frequently and screening and prophylaxis strategies are applied to at-risk individuals in nearly all transplant centers globally. Several high profile donor-derived infectious disease transmissions have been recognized; these reports have raised awareness of this rare complication of transplantation. Issues related to the epidemiology of, screening for, and management of proven or probable donor-derived infections are reviewed in this article.