Donor-Derived Dengue Virus Transmission in Kidney Transplant-A Report of Three Cases

Donor-derived dengue virus transmission is a rare but serious concern in hyperendemic regions, such as Mexico. Despite the risk, no standardized guidelines exist for dengue screening or organ acceptance criteria for donors. This report includes three kidney transplant recipients who developed dengue virus infection post-transplant. Case 1: Recipient 1 was a 41-year-old man with chronic kidney disease (CKD) who received a second kidney transplant from a donor with a history of dengue. He developed severe dengue and recovered with supportive care. Recipient 2 was a 41-year-old woman with rheumatoid arthritis and diabetic nephropathy who received the other kidney from the same donor. She died due to severe dengue, which caused respiratory failure and coagulopathy. Case 2: A 40-year-old woman with CKD secondary to polycystic kidney disease developed mild dengue after a 4-week surgical delay due to the donor's dengue infection and recovered with supportive care. These cases highlight the urgent need for guidelines that address donor-derived dengue transmission in transplant patients. The current algorithm used for evaluating at-risk donors and recipients of solid organ transplantation at the study center is presented. Evidence of donor-derived dengue virus transmission in the literature is limited. Decisions regarding organ procurement from potential donors should be evidence-based; however, there are no international guidelines designed to assist clinicians in this context. In the current study, three cases of donor-derived dengue virus transmission after kidney transplantation in an endemic region of Mexico are described.