Transmission of Rabies Virus from an Organ Donor to Four Transplant Recipients

Srinivasan, Arjun; Burton, Elizabeth C.; Kuehnert, Matthew J.; Rupprecht, Charles E.; Sutker, William L.; Ksiazek, Thomas G.; Paddock, Christopher D.; Guarner, Jeannette; Shieh, Wun Ju; Goldsmith, Cynthia S.; Hanlon, Cathleen A.; Zoretic, James; Fischbach, Bernard; Niezgoda, Michael; El-Feky, Waleed H.; Orciari, Lillian A.; Sanchez, Edmund Q.; Likos, Anna; Klintmalm, Göran B.; Cardo, Denise M.; LeDuc, James W.; Chamberland, Mary E.; Jernigan, Daniel B.; Zaki, Sherif R.

doi:10.1056/nejmoa043018

Cited by 435 publications

(249 citation statements)

References 13 publications

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“…Two reports have described transmission through SOT (162,346). In 2004, transmission of rabies virus from a common organ donor (with unrecognized rabies virus infection) through the transplantation of solid organs and vascular material was reported in the United States.…”

Section: Geographic Distributionmentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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SUMMARY In recent years, the increasing number of donors from different regions of the world is providing a new challenge for the management and selection of suitable donors. This is a worldwide problem in most countries with transplantation programs, especially due to the increase in immigration and international travel. This paper elaborates recommendations regarding the selection criteria for donors from foreign countries who could potentially transmit tropical or geographically restricted infections to solid-organ transplant recipients. For this purpose, an extensive review of the medical literature focusing on viral, fungal, and parasitic infections that could be transmitted during transplantation from donors who have lived or traveled in countries where these infections are endemic has been performed, with special emphasis on tropical and imported infections. The review also includes cases described in the literature as well as risks of transmission during transplantation, microbiological tests available, and recommendations for each infection. A table listing different infectious agents with their geographic distributions and specific recommendations is included.

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Section: Geographic Distributionmentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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“…Thus far, there have been 8 cases reported in corneal graft recipients [19,20], and 3 reports from the USA and Germany of recipients of solid organs (kidneys, liver, lungs, corneas and an arterial segment) from organ donors who died of unrecognized rabies encephalitis [20][21][22].…”

Section: Viral Transmissionmentioning

confidence: 99%

Perspectives in Diagnosis and Treatment of Rabies Viral Encephalitis: Insights from Pathogenesis

et al. 2016

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Rabies viral encephalitis, though one of the oldest recognized infectious disease of humans, remains an incurable, fatal encephalomyelitis, despite advances in understanding of its pathobiology. Advances in science have led us on the trail of the virus in the host, but the sanctuaries in which the virus remains hidden for its survival are unknown. Insights into host-pathogen interactions have facilitated evolving immunologic therapeutic strategies, though we are far from a cure. Most of the present-day knowledge has evolved from in vitro studies using fixed (attenuated) laboratory strains that may not be applicable in the clinical setting. Much remains to be unraveled about this elusive virus. This review attempts to re-examine the current advances in understanding of the pathobiology of the rabies virus that modulate the diagnosis, treatment, and prevention of this fatal disease.

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“…This is not an insignificant risk even in human-tohuman transplants, as a recent case of rabies in four organ recipients shows. 14 In pig-to-human transplants, this threat may be much more serious since there may be pathogens we have yet to discover even in pig species. Two xenotransplantable pathogens have already been identified, one already endemic in human beings (the cytomegalovirus in the herpes family 15 ) and one not found in the human species (the porcine endogenous retrovirus, or PERV 16 ).…”

Section: Casementioning

confidence: 99%

Casuistry and the Moral Continuum: Evaluating Animal Biotechnology

Fiester¹

2012

The Ethics of Animal Research

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While the science of animal biotechnology is advancing at a rapid pace, the ethical discussion about the boundaries the public might want to set is at the most nascent stage. There is a tendency in the public debate for opponents to favor an all-out ban on the science, while proponents want to grant it carte blanche. I argue that a more nuanced position on animal biotechnology considers individual projects to be located on a moral continuum, where some are clearly morally justified, others morally impermissible, and some lie in the ethical gray-zone. To begin to define this continuum, we use the bioethical method of casuistry to analyze one case at the end of moral permissibility, and we contrast it with a case that is located at the opposite end of the moral spectrum. I advocate this approach to assessing the moral merit of biotechnology projects because of its attention to the details of individual cases -the protocols, ends, and methods -on which an accurate moral judgment necessarily rests. CommentsReprinted ABSTRACT. While the science of animal biotechnology is advancing at a rapid pace, the ethical discussion about the boundaries the public might want to set is at the most nascent stage. There is a tendency in the public debate for opponents to favor an all-out ban on the science, while proponents want to grant it carte blanche. I argue that a more nuanced position on animal biotechnology considers individual projects to be located on a moral continuum, where some are clearly morally justified, others morally impermissible, and some lie in the ethical gray-zone. To begin to define this continuum, we use the bioethical method of casuistry to analyze one case at the end of moral permissibility, and we contrast it with a case that is located at the opposite end of the moral spectrum. I advocate this approach to assessing the moral merit of biotechnology projects because of its attention to the details of individual cases -the protocols, ends, and methods -on which an accurate moral judgment necessarily rests.

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Transmission of Rabies Virus from an Organ Donor to Four Transplant Recipients

Abstract: This report documenting the transmission of rabies virus from an organ donor to multiple recipients underscores the challenges of preventing and detecting transmission of unusual pathogens through transplantation.

Cited by 435 publications

References 13 publications

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

Perspectives in Diagnosis and Treatment of Rabies Viral Encephalitis: Insights from Pathogenesis

Casuistry and the Moral Continuum: Evaluating Animal Biotechnology

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