Herpes simplex virus‐2 transmission following solid organ transplantation: Donor‐derived infection and transplantation from prior organ recipients

Abstract

Donor-derived HSV infection affected two clusters of recipients because of transplantation of organs from a prior organ recipient. HSV should be considered as a possible cause of illness in febrile SOT recipients in the immediate post-transplant period and may cause disseminated disease and re-infection in HSV-2-seropositive recipients. Testing of HSV serology and prophylaxis may be considered in SOT recipients not receiving cytomegalovirus prophylaxis.

Infectious Disease Transmission in Solid Organ Transplantation: Donor Evaluation, Recipient Risk, and Outcomes of Transmission

“…A case of donor-derived HSV-2 infection affecting 6 solid organ recipients occurred in Victoria in 2014. 18,215 Lungs, kidneys, pancreas, and liver were retrieved from the original donor and transplanted into 4 recipients. The recipient of the kidney-pancreas had an acute myocardial infarction and cardiac arrest 2 days posttransplant and subsequently deteriorated, with brain death declared on day 9.…”

Donor derived HSV hepatitis in a kidney transplant recipient leading to liver fibrosis and portal hypertension

“…Much less commonly, HSV is transmitted from the donor at the time of transplantation. As defined by the Disease Transmission Advisory Committee, there have been two reports of “probable” donor transmission of HSV, but no cases of “proven” donor transmission of HSV reported in the literature. Our report represents another case of probable donor‐derived HSV hepatitis using the definitions referenced above.…”

Donor‐derived herpes simplex virus hepatitis in a kidney transplant recipient and review of the literature

“…5 Macesic et al in 2017 reported two clusters of possible and probable DDHSV2 infection. 6 Short nucleotide sequencing of HSV2 isolates from three patients showed 100% homology, but this methodology was non-reliable as there was 98%-100% homology compared with other HSV2 sequences in the GenBank. 6 Table 2 summarizes nine cases of proven and probable DDHSV hepatitis as defined by DTAC.…”

“…Two studies used molecular fingerprinting with restriction endonuclease pattern and short nucleotide sequencing of HSV genome to prove donor transmission, but these methods lack sufficient capability to distinguish HSV isolates. 5,6 In 1988 Koneru et al reported two cases of DDHSV hepatitis in two HSV pre-transplant seronegative kidney recipients from the same donor who was HSV1 and HSV2 seropositive. 5 Restriction endonuclease patterns of HSV2 strains from the two kidney recipients showed a similar cleavage pattern, however this methodology, unlike whole genome sequencing, cannot confirm complete genetic identity.…”