Transmission of lymphocytic choriomeningitis virus by organ transplantation.

@article{citeulike:694489, abstract = {BACKGROUND: In December 2003 and April 2005, signs and symptoms suggestive of infection developed in two groups of recipients of solid-organ transplants. Each cluster was investigated because diagnostic evaluations were unrevealing, and in each a common donor was recognized. METHODS: We examined clinical specimens from the two donors and eight recipients, using viral culture, electron microscopy, serologic testing, molecular analysis, and histopathological examination with immunohistochemical staining to identify a cause. Epidemiologic investigations, including interviews, environmental assessments, and medical-record reviews, were performed to characterize clinical courses and to determine the cause of the illnesses. RESULTS: Laboratory testing revealed lymphocytic choriomeningitis virus (LCMV) in all the recipients, with a single, unique strain of LCMV identified in each cluster. In both investigations, LCMV could not be detected in the organ donor. In the 2005 cluster, the donor had had contact in her home with a pet hamster infected with an LCMV strain identical to that detected in the organ recipients; no source of LCMV infection was found in the 2003 cluster. The transplant recipients had abdominal pain, altered mental status, thrombocytopenia, elevated aminotransferase levels, coagulopathy, graft dysfunction, and either fever or leukocytosis within three weeks after transplantation. Diarrhea, peri-incisional rash, renal failure, and seizures were variably present. Seven of the eight recipients died, 9 to 76 days after transplantation. One recipient, who received ribavirin and reduced levels of immunosuppressive therapy, survived. CONCLUSIONS: We document two clusters of LCMV infection transmitted through organ transplantation.}, address = {Rhode Island Hospital and Brown Medical School, Providence, USA.}, author = {Fischer, S. A. and Graham, M. B. and Kuehnert, M. J. and Kotton, C. N. and Srinivasan, A. and Marty, F. M. and Comer, J. A. and Guarner, J. and Paddock, C. D. and DeMeo, D. L. and Shieh, W. J. and Erickson, B. R. and Bandy, U. and DeMaria, A. and Davis, J. P. and Delmonico, F. L. and Pavlin, B. and Likos, A. and Vincent, M. J. and Sealy, T. K. and Goldsmith, C. S. and Jernigan, D. B. and Rollin, P. E. and Packard, M. M. and Patel, M. and Rowland, C. and Helfand, R. F. and Nichol, S. T. and Fishman, J. A. and Ksiazek, T. and Zaki, S. R. and }, citeulike-article-id = {694489}, doi = {http://dx.doi.org/10.1056/NEJMoa053240}, issn = {1533-4406}, journal = {N Engl J Med}, keywords = {human, lcmv, transmission, transplantation}, month = {May}, number = {21}, pages = {2235--2249}, posted-at = {2008-04-07 09:42:42}, priority = {0}, title = {Transmission of lymphocytic choriomeningitis virus by organ transplantation.}, url = {http://dx.doi.org/10.1056/NEJMoa053240}, volume = {354}, year = {2006} }

TY - JOUR ID - citeulike:694489 L3 - citeulike-article-id:694489 TI - Transmission of lymphocytic choriomeningitis virus by organ transplantation. JF - N Engl J Med VL - 354 IS - 21 SP - 2235 EP - 2249 AD - Rhode Island Hospital and Brown Medical School, Providence, USA. SN - 1533-4406 N2 - BACKGROUND: In December 2003 and April 2005, signs and symptoms suggestive of infection developed in two groups of recipients of solid-organ transplants. Each cluster was investigated because diagnostic evaluations were unrevealing, and in each a common donor was recognized. METHODS: We examined clinical specimens from the two donors and eight recipients, using viral culture, electron microscopy, serologic testing, molecular analysis, and histopathological examination with immunohistochemical staining to identify a cause. Epidemiologic investigations, including interviews, environmental assessments, and medical-record reviews, were performed to characterize clinical courses and to determine the cause of the illnesses. RESULTS: Laboratory testing revealed lymphocytic choriomeningitis virus (LCMV) in all the recipients, with a single, unique strain of LCMV identified in each cluster. In both investigations, LCMV could not be detected in the organ donor. In the 2005 cluster, the donor had had contact in her home with a pet hamster infected with an LCMV strain identical to that detected in the organ recipients; no source of LCMV infection was found in the 2003 cluster. The transplant recipients had abdominal pain, altered mental status, thrombocytopenia, elevated aminotransferase levels, coagulopathy, graft dysfunction, and either fever or leukocytosis within three weeks after transplantation. Diarrhea, peri-incisional rash, renal failure, and seizures were variably present. Seven of the eight recipients died, 9 to 76 days after transplantation. One recipient, who received ribavirin and reduced levels of immunosuppressive therapy, survived. CONCLUSIONS: We document two clusters of LCMV infection transmitted through organ transplantation. KW - human KW - lcmv KW - transmission KW - transplantation AU - Fischer, SA AU - Graham, MB AU - Kuehnert, MJ AU - Kotton, CN AU - Srinivasan, A AU - Marty, FM AU - Comer, JA AU - Guarner, J AU - Paddock, CD AU - DeMeo, DL AU - Shieh, WJ AU - Erickson, BR AU - Bandy, U AU - DeMaria, A AU - Davis, JP AU - Delmonico, FL AU - Pavlin, B AU - Likos, A AU - Vincent, MJ AU - Sealy, TK AU - Goldsmith, CS AU - Jernigan, DB AU - Rollin, PE AU - Packard, MM AU - Patel, M AU - Rowland, C AU - Helfand, RF AU - Nichol, ST AU - Fishman, JA AU - Ksiazek, T AU - Zaki, SR PY - 2006/05/25/ UR - http://dx.doi.org/10.1056/NEJMoa053240 ER -