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Assessment of Chimeric Antigen Receptor T Cell-Associated Toxicities Using an Acute Lymphoblastic Leukemia Patient-Derived Xenograft Mouse Model
Published on: February 10, 2023
Solid organ transplant-associated lymphocytic choriomeningitis, United States, 2011
Adam Macneil1, Ute Ströher, Eileen Farnon
1Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Insights
Organ transplant recipients can contract lymphocytic choriomeningitis virus (LCMV) from donors. This fourth cluster highlights the severe risk, with two of four recipients dying from LCMV infection.
Area of Science:
- Virology
- Infectious Diseases
- Transplant Medicine
Background:
- Lymphocytic choriomeningitis virus (LCMV) is a known cause of organ transplant-associated infections.
- Previous clusters in the US resulted in high mortality among organ transplant recipients.
Observation:
- A fourth cluster of LCMV infection was identified in February 2011 following organ transplantation.
- The organ donor died from diabetic ketoacidosis and generalized brain edema.
- Four recipients received organs (kidneys, liver, lung) from the infected donor, all developing severe post-transplant illness.
Findings:
- LCMV infection was confirmed in the donor and all four recipients using reverse transcription PCR.
- Identical viral sequences from the LCMV large segment were found in all five individuals.
- Two of the four organ transplant recipients in this cluster survived despite severe illness.
Implications:
- LCMV infection is a critical consideration for unexplained severe post-transplant illness.
- This case underscores the importance of donor screening and awareness of zoonotic viral transmission in transplantation.
- Prompt diagnosis and management of LCMV are crucial for improving outcomes in organ transplant recipients.
Abstract:
Three clusters of organ transplant-associated lymphocytic choriomeningitis virus (LCMV) transmissions have been identified in the United States; 9 of 10 recipients died. In February 2011, we identified a fourth cluster of organ transplant-associated LCMV infections. Diabetic ketoacidosis developed in the organ donor in December 2010; she died with generalized brain edema after a short hospitalization. Both kidneys, liver, and lung were transplanted to 4 recipients; in all 4, severe posttransplant illness developed; 2 recipients died. Through multiple diagnostic methods, we identified LCMV infection in all persons, including in at least 1 sample from the donor and 4 recipients by reverse transcription PCR, and sequences of a 396-bp fragment of the large segment of the virus from all 5 persons were identical. In this cluster, all recipients developed severe illness, but 2 survived. LCMV infection should be considered as a possible cause of severe posttransplant illness.
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