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J Infect Dis. 2017 Mar 15;215(6):896-901. doi: 10.1093/infdis/jix040.

A Cluster of Fatal Tick-borne Encephalitis Virus Infection in Organ Transplant Setting.

Author information

1
Department of Infectious Diseases, Warsaw Medical University, Warsaw, Poland.
2
Department of Immunopathology of Infectious and Parasitic Diseases, Warsaw Medical University, Warsaw, Poland.
3
Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan.
4
Department of Microbiology, Warsaw Medical University, Warsaw, Poland.
5
Department of General and Endocrine Surgery and Transplantation Medical University of Gdansk, Gdansk, Poland.
6
Intensive Care Unit, Regional Hospital, Elblag, Poland.
7
Department of Immunology, Warsaw Medical University, Warsaw, Poland.
8
Department of Nephrology, Transplantation and Internal Diseases, Gdansk Medical University, Gdansk, Poland.
9
Department of Nephrology, Kraków Medical University Hospital, Poland.

Abstract

Background:

Tick-borne encephalitis virus (TBEV) infection has become a major health problem in Europe and is currently a common cause of viral brain infection in many countries. Encephalitis in transplant recipients, althrough rare, is becoming a recognized complication. Our study provides the first description of transmission of TBEV through transplantation of solid organs.

Methods:

Three patients who received solid organ transplants from a single donor (2 received kidney, and 1 received liver) developed encephalitis 17-49 days after transplantation and subsequently died. Blood and autopsy tissue samples were tested by next-generation sequencing (NGS) and reverse transcription polymerase chain reaction (RT-PCR).

Results:

All 3 recipients were first analyzed in autopsy brain tissue samples and/or cerebrospinal fluid by NGS, which yielded 24-52 million sequences per sample and 9-988 matched TBEV sequences in each patient. The presence of TBEV was confirmed by RT-PCR in all recipients and in the donor, and direct sequencing of amplification products corroborated the presence of the same viral strain.

Conclusions:

We demonstrated transmission of TBEV by transplantation of solid organs. In such a setting, TBEV infection may be fatal, probably due to pharmacological immunosuppression. Organ donors should be screened for TBEV when coming from or visiting endemic areas.

KEYWORDS:

encephalitis; transplantation; TBEV

PMID:
28453842
DOI:
10.1093/infdis/jix040
[Indexed for MEDLINE]

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