Considerations on infectious complications using a drowned lung for transplantation

Abstract

Summary Recently, the applicability of lungs from drowned victims for transplantation has been anecdotically described in literature. However, no data exist about hazards or limitations. Herein, we describe a case of lung transplantation from a submersion victim and the subsequent development of an Aeromonas hydrophila infection in the implanted organ. Based on this case we propose standard procedures, which should be followed when considering drowned donor lungs, in order to minimize risks for infectious complications.

Donor cornea tissue in cases of drowning or water submersion: eye banks practice patterns and tissue outcomes

“…is the bacteria most commonly found in lung transplantation donor victims of saltwater and freshwater drowning or submersion, and is highly susceptible to antibiotics (Bonatti et al 2012; Hoetzenecker et al 2010). Case studies have illustrated instances of recipient infection after transplant from a drowned donor; however, in both cases the infection was identified and was successfully managed (Hoetzenecker et al 2010; Kim et al 2015). Prophylactic treatment of corneal tissue with antimicrobials and screening for tissue integrity, which is currently standard protocol for tissues from all donors, likely minimizes risk adequately.…”

Scedosporiosis in a Combined Kidney and Liver Transplant Recipient: A Case Report of Possible Transmission from a Near-Drowning Donor

“…Gram negative bacteria are most often the causative agents in near-drowning cases [13]. Aeromonas spp.…”

“…naturally thrive in fresh and brackish waters and have been isolated in humans in wound and gastrointestinal infections after exposure to contaminated water. Other potential bacterial pathogens include Pseudomonas aeruginosa , Legionella spp., Klebsiella spp., and other Enterobacteriaceae [13]. Scedosporium spp.…”

Selective culturing and genus-specific PCR detection for identification of Aeromonas in tissue samples to assist the medico-legal diagnosis of death by drowning

“…On the other hand, however, Aeromonas species are well recognized as opportunistic human pathogens associated with gastroenteritis and a range of extraintestinal infections including pulmonary infections. In fact, Aeromonas hydrophila is the most frequently reported Aeromonas species causing near-drowningassociated pneumonia [28][29][30][31][32][33][34]. Furthermore, the presence of Aeromonas in lungs from drowned victims that are considered for transplantation may hold a potential risk for subsequent development of Aeromonas infection in the implanted organ [28].…”