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Successful transplantation of organs retrieved from donors with bacterial meningitis
A López-Navidad1, P Domingo, F Caballero
1Transplant Coordination Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Background:
The shortage of organs for transplantation is the most important factor limiting the number of transplants performed. Consequently, in recent years, criteria for considering a patient as a potential organ donor have been broadened.
Methods:
From 1995 through 1996, we have retrieved organs from five donors who were brain dead because of bacterial meningitis. The causative microorganisms were Neisseria meningitidis in one patient, Streptococcus pneumoniae in three patients, and Escherichia coli in one patient. Fifteen organs were retrieved and transplanted into 16 recipients. All the donors and recipients received adequate antibiotic therapy.
Results:
None of the recipients developed infectious complications caused by the meningeal pathogens. After a follow-up ranging from 4 to 30 months, 12 patients are alive with functioning grafts. The cause of death was noninfectious in the four patients who died.
Conclusions:
Our study demonstrates that patients with brain death caused by bacterial meningitis due to meningococci, pneumococci, or E coli may be suitable organ donors. Transplantation of organs from such donors does not increase the risk of infection transmission to the recipient, provided that both donor and recipient had received adequate antibiotic therapy.
Insights
Brain-dead patients with bacterial meningitis can be safe organ donors. Transplanting organs from these donors, with adequate antibiotic therapy for both parties, does not transmit infections to recipients.
Area of Science:
- Transplantation immunology
- Infectious disease transmission
- Microbiology
Background:
- Organ transplantation is limited by donor shortages.
- Expanded donor criteria are necessary to meet demand.
- Bacterial meningitis is a potential contraindication for organ donation.
Observation:
- Five brain-dead organ donors with bacterial meningitis (Neisseria meningitidis, Streptococcus pneumoniae, Escherichia coli) were identified.
- Fifteen organs were retrieved and transplanted into 16 recipients.
- All donors and recipients received appropriate antibiotic treatment.
Findings:
- No recipients developed infections from the meningeal pathogens.
- Graft survival was successful in 12 out of 16 recipients after 4–30 months.
- Deaths in recipients were due to non-infectious causes.
Implications:
- Brain death due to specific bacterial meningitis does not preclude organ donation.
- Adequate antibiotic prophylaxis in donors and recipients prevents pathogen transmission.
- This widens the pool of potential organ donors, improving transplantation rates.