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Fatal Apophysomyces elegans infection transmitted by deceased donor renal allografts.

Publication ,  Journal Article
Alexander, BD; Schell, WA; Siston, AM; Rao, CY; Bower, WA; Balajee, SA; Howell, DN; Moore, ZS; Noble-Wang, J; Rhyne, JA; Fleischauer, AT ...
Published in: Am J Transplant
September 2010

Two patients developed renal mucormycosis following transplantation of kidneys from the same donor, a near-drowning victim in a motor vehicle crash. Genotypically, indistinguishable strains of Apophysomyces elegans were recovered from both recipients. We investigated the source of the infection including review of medical records, environmental sampling at possible locations of contamination and query for additional cases at other centers. Histopathology of the explanted kidneys revealed extensive vascular invasion by aseptate, fungal hyphae with relative sparing of the renal capsules suggesting a vascular route of contamination. Disseminated infection in the donor could not be definitively established. A. elegans was not recovered from the same lots of reagents used for organ recovery or environmental samples and no other organ transplant-related cases were identified. This investigation suggests either isolated contamination of the organs during recovery or undiagnosed disseminated donor infection following a near-drowning event. Although no changes to current organ recovery or transplant procedures are recommended, public health officials and transplant physicians should consider the possibility of mucormycosis transmitted via organs in the future, particularly for near-drowning events. Attention to aseptic technique during organ recovery and processing is re-emphasized.

Duke Scholars

Published In

Am J Transplant

DOI

EISSN

1600-6143

Publication Date

September 2010

Volume

10

Issue

9

Start / End Page

2161 / 2167

Location

United States

Related Subject Headings

  • Transplantation, Homologous
  • Tissue and Organ Harvesting
  • Surgery
  • Near Drowning
  • Mucormycosis
  • Mucorales
  • Middle Aged
  • Medical Futility
  • Male
  • Kidney Transplantation
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Alexander, B. D., Schell, W. A., Siston, A. M., Rao, C. Y., Bower, W. A., Balajee, S. A., … Park, B. J. (2010). Fatal Apophysomyces elegans infection transmitted by deceased donor renal allografts. Am J Transplant, 10(9), 2161–2167. https://doi.org/10.1111/j.1600-6143.2010.03216.x
Alexander, B. D., W. A. Schell, A. M. Siston, C. Y. Rao, W. A. Bower, S. A. Balajee, D. N. Howell, et al. “Fatal Apophysomyces elegans infection transmitted by deceased donor renal allografts.Am J Transplant 10, no. 9 (September 2010): 2161–67. https://doi.org/10.1111/j.1600-6143.2010.03216.x.
Alexander BD, Schell WA, Siston AM, Rao CY, Bower WA, Balajee SA, et al. Fatal Apophysomyces elegans infection transmitted by deceased donor renal allografts. Am J Transplant. 2010 Sep;10(9):2161–7.
Alexander, B. D., et al. “Fatal Apophysomyces elegans infection transmitted by deceased donor renal allografts.Am J Transplant, vol. 10, no. 9, Sept. 2010, pp. 2161–67. Pubmed, doi:10.1111/j.1600-6143.2010.03216.x.
Alexander BD, Schell WA, Siston AM, Rao CY, Bower WA, Balajee SA, Howell DN, Moore ZS, Noble-Wang J, Rhyne JA, Fleischauer AT, Maillard JM, Kuehnert M, Vikraman D, Collins BH, Marroquin CE, Park BJ. Fatal Apophysomyces elegans infection transmitted by deceased donor renal allografts. Am J Transplant. 2010 Sep;10(9):2161–2167.
Journal cover image

Published In

Am J Transplant

DOI

EISSN

1600-6143

Publication Date

September 2010

Volume

10

Issue

9

Start / End Page

2161 / 2167

Location

United States

Related Subject Headings

  • Transplantation, Homologous
  • Tissue and Organ Harvesting
  • Surgery
  • Near Drowning
  • Mucormycosis
  • Mucorales
  • Middle Aged
  • Medical Futility
  • Male
  • Kidney Transplantation