Organ transplantation from a donor colonized with a multidrug-resistant organism: a case report

Area of Science:

• Infectious Diseases
• Transplant Surgery
• Microbiology

Background:

• Rising prevalence of multidrug-resistant organisms (MDROs) in intensive care units globally.
• Carbapenem-resistant Klebsiella pneumoniae (CR-KP) poses a significant threat in healthcare settings.
• Organ transplantation is a life-saving procedure but carries risks of infectious complications.

Observation:

• A deceased multiorgan donor was an asymptomatic carrier of CR-KP in the respiratory tract.
• CR-KP was undiagnosed before organ procurement and transplantation.
• Four recipients received organs (2 kidneys, 1 liver, 2 lungs).

Findings:

• Three recipients (kidney, liver, one lung) had uneventful post-transplant courses with no CR-KP transmission.
• One lung recipient developed CR-KP bacteremic pneumonia 4 weeks post-transplantation, leading to death.
• Graft outcomes were generally positive, with no widespread adverse events noted.

Implications:

• Careful donor screening and recipient selection are crucial when considering organs from CR-KP positive donors.
• Transplantation of organs from asymptomatic CR-KP positive donors may be feasible under specific circumstances.
• Further research is needed to establish clear guidelines for using organs from MDRO-colonized donors.