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Donor-Derived Tuberculosis in 3 Solid Organ Transplant Recipients From the Same Donor
Paulina Vega1,2, Renee Newby1, Rachel A Bender Ignacio1,2
1Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA.
Open Forum Infectious Diseases
|July 29, 2025
Summary
Donor-derived tuberculosis is a rare but serious complication after organ transplants. Early diagnosis and treatment are crucial for transplant recipients presenting with unexplained fevers.
Area of Science:
- Nephrology
- Hepatology
- Infectious Diseases
Background:
- Donor-derived tuberculosis is a rare complication following solid organ transplantation.
- Tuberculosis screening is not a standard prerequisite for most organ donors.
- Donor-derived tuberculosis typically manifests earlier than reactivation tuberculosis.
Observation:
- Three cases of donor-derived tuberculosis occurred in recipients of kidneys and liver from a single donor.
- Recipients presented with unexplained fevers 4-5 weeks post-transplantation.
- Initial broad-spectrum antibiotic therapy was ineffective in all three patients.
Findings:
- Mycobacterium tuberculosis was identified in all three recipients via culture and molecular methods.
- All recipients eventually received successful tuberculosis therapy.
- Patients experienced significant morbidity and prolonged hospitalizations.
Implications:
- Donor-derived tuberculosis should be considered in the differential diagnosis of unexplained fever in solid organ transplant recipients.
- Implementing screening protocols for donors with tuberculosis risk factors, especially deceased donors, is recommended.
- This highlights the importance of donor screening to prevent transmission of infectious diseases.
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