We describe the presentation of a SOT recipient who developed strongyloidiasis and the investigation that led to the determination of donor-derived infection. We assess the outcomes of this investigation based on AST’s guidelines.
Disseminated strongyloidiasis and Klebsiella bacteremia were diagnosed in a 36-year old male 5 weeks after kidney/pancreas transplantation. The recipient had no known risk factors for strongyloidiasis and pre-transplant serum was negative for Strongyloides antibody. Both organs were removed as a result of complications from this infection. The serum of the Mexico-born donor, tested after the recipient’s diagnosis, was positive. AST’s guidelines were not followed in this case. Five additional organs from this donor were transplanted in four recipients, all of whom received pre-emptive therapy with ivermectin and showed no evidence of infection after therapy, when evaluated 2-3 months post-transplant.
Donor-derived strongyloidiasis is a serious and potentially fatal infection in SOT recipients. This case is an example of the adverse outcomes that may result when targeted donor screening is not conducted. When screening guidelines are adhered to, targeted screening and provision of pre-emptive therapy may prevent donor-derived strongyloidiasis.
E. B. Gray, None
P. Chin-Hong, None
J. C. Ling, None
S. Huprikar, None
S. Montgomery, None
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