Transplantation of organs from deceased donors with meningitis and encephalitis: a UK registry analysis.

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Trotter, Patrick B 
Robb, Matthew 
Hulme, William 
Watson, Christopher JE 

BACKGROUND: Deceased organ donors, where the cause of death is meningitis or encephalitis, are a potential concern because of the risks of transmission of a potentially fatal infection to recipients. METHODS: Using the UK Transplant Registry, a retrospective cohort analysis of deceased organ donors in the UK was undertaken to better understand the extent to which organs from deceased donors with meningitis and/or encephalitis (M/E) (of both known and unknown cause) have been used for transplantation, and to determine the associated recipient outcomes. RESULTS: Between 2003 and 2015, 258 deceased donors with M/E were identified and the causative agent was known in 188 (72.9%). These donors provided 899 solid organs for transplantation (455 kidneys and 444 other organs). The only recorded case of disease transmission was from a donor with encephalitis of unknown cause at time of transplantation who transmitted a fatal nematode infection to 2 kidney transplant recipients. A further 3 patients (2 liver and 1 heart recipient) died within 30 days of transplantation from a neurological cause (cerebrovascular accident) with no suggestion of disease transmission. Overall, patient and graft survival in recipients of organs from donors with M/E were similar to those for all other types of deceased organ donor. CONCLUSION: Donors dying with M/E represent a valuable source of organs for transplantation. The risk of disease transmission is low but, where the causative agent is unknown, caution is required.

disease, donor, encephalitis, meningitis, transmission, transplantation, Adolescent, Adult, Allografts, Disease Transmission, Infectious, Encephalitis, Female, Graft Survival, Humans, Male, Meningitis, Middle Aged, Organ Transplantation, Practice Guidelines as Topic, Registries, Retrospective Studies, Tissue Donors, Tissue and Organ Procurement, Treatment Outcome, United Kingdom, Young Adult
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Transpl Infect Dis
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National Institute of Health Research, Blood and Transplant Research Unit (NIHR BTRU) on Organ Donation and Transplantation at the University of Cambridge in collaboration with Newcastle University and in partnership with NHS Blood and Transplant (NHSBT), and the NIHR Cambridge Biomedical Research Centre