Herpes simplex virus-2 transmission following solid organ transplantation: Donor-derived infection and transplantation from prior organ recipients

Nenad Macesic, Iain J. Abbott, Matthew Kaye, Julian Druce, Allan R. Glanville, Paul J. Gow, Peter D. Hughes, Tony M. Korman, William R. Mulley, Phillip J. O'Connell, Helen Opdam, Miranda Paraskeva, Matthew C. Pitman, Stella Setyapranata, William D. Rawlinson, Paul D.R. Johnson

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Owing to limited availability of donor organs, previous solid organ transplant (SOT) recipients are increasingly considered as potential organ donors. We report donor-derived transmission of herpes simplex virus type-2 (HSV-2) to two clusters of SOT recipients with transmission from the original donor and an HSV-2–infected recipient who subsequently became a donor. Methods: We reviewed medical records of the donors and recipients in both clusters. Pre-transplant serology and virological features of HSV-2 were characterized. Genotyping of HSV-2 isolates to determine potential for donor transmission of HSV-2 through transplantation of organs from prior organ recipients was performed. Results: A kidney-pancreas recipient died day 9 post transplant. Following confirmation of brain death, the lungs and recently transplanted kidney were donated to two further recipients. The liver was not retrieved, but biopsy confirmed HSV-2 infection. Testing on the original donor showed negative HSV-2 polymerase chain reaction and HSV immunoglobulin (Ig)M, but positive HSV-2 IgG. The liver recipient from the original donor developed HSV-2 hepatitis and cutaneous infection that responded to treatment with intravenous acyclovir. In the second cluster, lung and kidney recipients both developed HSV-2 viremia that was successfully treated with antiviral therapy. Genotyping of all HSV-2–positive samples showed 100% sequence homology for three recipients. Conclusions: Donor-derived HSV infection affected two clusters of recipients because of transplantation of organs from a prior organ recipient. HSV should be considered as a possible cause of illness in febrile SOT recipients in the immediate post-transplant period and may cause disseminated disease and re-infection in HSV-2–seropositive recipients. Testing of HSV serology and prophylaxis may be considered in SOT recipients not receiving cytomegalovirus prophylaxis.

Original languageEnglish
Article numbere12739
Number of pages8
JournalTransplant Infectious Disease
Volume19
Issue number5
DOIs
Publication statusPublished - 1 Oct 2017

Keywords

  • allograft re-use
  • donor-derived infection
  • herpes simplex virus hepatitis
  • transplantation

Cite this

Macesic, Nenad ; Abbott, Iain J. ; Kaye, Matthew ; Druce, Julian ; Glanville, Allan R. ; Gow, Paul J. ; Hughes, Peter D. ; Korman, Tony M. ; Mulley, William R. ; O'Connell, Phillip J. ; Opdam, Helen ; Paraskeva, Miranda ; Pitman, Matthew C. ; Setyapranata, Stella ; Rawlinson, William D. ; Johnson, Paul D.R. / Herpes simplex virus-2 transmission following solid organ transplantation : Donor-derived infection and transplantation from prior organ recipients. In: Transplant Infectious Disease. 2017 ; Vol. 19, No. 5.
@article{7fc6678bce02460d9a3017fcfed1f86c,
title = "Herpes simplex virus-2 transmission following solid organ transplantation: Donor-derived infection and transplantation from prior organ recipients",
abstract = "Background: Owing to limited availability of donor organs, previous solid organ transplant (SOT) recipients are increasingly considered as potential organ donors. We report donor-derived transmission of herpes simplex virus type-2 (HSV-2) to two clusters of SOT recipients with transmission from the original donor and an HSV-2–infected recipient who subsequently became a donor. Methods: We reviewed medical records of the donors and recipients in both clusters. Pre-transplant serology and virological features of HSV-2 were characterized. Genotyping of HSV-2 isolates to determine potential for donor transmission of HSV-2 through transplantation of organs from prior organ recipients was performed. Results: A kidney-pancreas recipient died day 9 post transplant. Following confirmation of brain death, the lungs and recently transplanted kidney were donated to two further recipients. The liver was not retrieved, but biopsy confirmed HSV-2 infection. Testing on the original donor showed negative HSV-2 polymerase chain reaction and HSV immunoglobulin (Ig)M, but positive HSV-2 IgG. The liver recipient from the original donor developed HSV-2 hepatitis and cutaneous infection that responded to treatment with intravenous acyclovir. In the second cluster, lung and kidney recipients both developed HSV-2 viremia that was successfully treated with antiviral therapy. Genotyping of all HSV-2–positive samples showed 100{\%} sequence homology for three recipients. Conclusions: Donor-derived HSV infection affected two clusters of recipients because of transplantation of organs from a prior organ recipient. HSV should be considered as a possible cause of illness in febrile SOT recipients in the immediate post-transplant period and may cause disseminated disease and re-infection in HSV-2–seropositive recipients. Testing of HSV serology and prophylaxis may be considered in SOT recipients not receiving cytomegalovirus prophylaxis.",
keywords = "allograft re-use, donor-derived infection, herpes simplex virus hepatitis, transplantation",
author = "Nenad Macesic and Abbott, {Iain J.} and Matthew Kaye and Julian Druce and Glanville, {Allan R.} and Gow, {Paul J.} and Hughes, {Peter D.} and Korman, {Tony M.} and Mulley, {William R.} and O'Connell, {Phillip J.} and Helen Opdam and Miranda Paraskeva and Pitman, {Matthew C.} and Stella Setyapranata and Rawlinson, {William D.} and Johnson, {Paul D.R.}",
year = "2017",
month = "10",
day = "1",
doi = "10.1111/tid.12739",
language = "English",
volume = "19",
journal = "Transplant Infectious Disease",
issn = "1398-2273",
publisher = "Wiley-Blackwell",
number = "5",

}

Macesic, N, Abbott, IJ, Kaye, M, Druce, J, Glanville, AR, Gow, PJ, Hughes, PD, Korman, TM, Mulley, WR, O'Connell, PJ, Opdam, H, Paraskeva, M, Pitman, MC, Setyapranata, S, Rawlinson, WD & Johnson, PDR 2017, 'Herpes simplex virus-2 transmission following solid organ transplantation: Donor-derived infection and transplantation from prior organ recipients' Transplant Infectious Disease, vol. 19, no. 5, e12739. https://doi.org/10.1111/tid.12739

Herpes simplex virus-2 transmission following solid organ transplantation : Donor-derived infection and transplantation from prior organ recipients. / Macesic, Nenad; Abbott, Iain J.; Kaye, Matthew; Druce, Julian; Glanville, Allan R.; Gow, Paul J.; Hughes, Peter D.; Korman, Tony M.; Mulley, William R.; O'Connell, Phillip J.; Opdam, Helen; Paraskeva, Miranda; Pitman, Matthew C.; Setyapranata, Stella; Rawlinson, William D.; Johnson, Paul D.R.

In: Transplant Infectious Disease, Vol. 19, No. 5, e12739, 01.10.2017.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Herpes simplex virus-2 transmission following solid organ transplantation

T2 - Donor-derived infection and transplantation from prior organ recipients

AU - Macesic, Nenad

AU - Abbott, Iain J.

AU - Kaye, Matthew

AU - Druce, Julian

AU - Glanville, Allan R.

AU - Gow, Paul J.

AU - Hughes, Peter D.

AU - Korman, Tony M.

AU - Mulley, William R.

AU - O'Connell, Phillip J.

AU - Opdam, Helen

AU - Paraskeva, Miranda

AU - Pitman, Matthew C.

AU - Setyapranata, Stella

AU - Rawlinson, William D.

AU - Johnson, Paul D.R.

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Background: Owing to limited availability of donor organs, previous solid organ transplant (SOT) recipients are increasingly considered as potential organ donors. We report donor-derived transmission of herpes simplex virus type-2 (HSV-2) to two clusters of SOT recipients with transmission from the original donor and an HSV-2–infected recipient who subsequently became a donor. Methods: We reviewed medical records of the donors and recipients in both clusters. Pre-transplant serology and virological features of HSV-2 were characterized. Genotyping of HSV-2 isolates to determine potential for donor transmission of HSV-2 through transplantation of organs from prior organ recipients was performed. Results: A kidney-pancreas recipient died day 9 post transplant. Following confirmation of brain death, the lungs and recently transplanted kidney were donated to two further recipients. The liver was not retrieved, but biopsy confirmed HSV-2 infection. Testing on the original donor showed negative HSV-2 polymerase chain reaction and HSV immunoglobulin (Ig)M, but positive HSV-2 IgG. The liver recipient from the original donor developed HSV-2 hepatitis and cutaneous infection that responded to treatment with intravenous acyclovir. In the second cluster, lung and kidney recipients both developed HSV-2 viremia that was successfully treated with antiviral therapy. Genotyping of all HSV-2–positive samples showed 100% sequence homology for three recipients. Conclusions: Donor-derived HSV infection affected two clusters of recipients because of transplantation of organs from a prior organ recipient. HSV should be considered as a possible cause of illness in febrile SOT recipients in the immediate post-transplant period and may cause disseminated disease and re-infection in HSV-2–seropositive recipients. Testing of HSV serology and prophylaxis may be considered in SOT recipients not receiving cytomegalovirus prophylaxis.

AB - Background: Owing to limited availability of donor organs, previous solid organ transplant (SOT) recipients are increasingly considered as potential organ donors. We report donor-derived transmission of herpes simplex virus type-2 (HSV-2) to two clusters of SOT recipients with transmission from the original donor and an HSV-2–infected recipient who subsequently became a donor. Methods: We reviewed medical records of the donors and recipients in both clusters. Pre-transplant serology and virological features of HSV-2 were characterized. Genotyping of HSV-2 isolates to determine potential for donor transmission of HSV-2 through transplantation of organs from prior organ recipients was performed. Results: A kidney-pancreas recipient died day 9 post transplant. Following confirmation of brain death, the lungs and recently transplanted kidney were donated to two further recipients. The liver was not retrieved, but biopsy confirmed HSV-2 infection. Testing on the original donor showed negative HSV-2 polymerase chain reaction and HSV immunoglobulin (Ig)M, but positive HSV-2 IgG. The liver recipient from the original donor developed HSV-2 hepatitis and cutaneous infection that responded to treatment with intravenous acyclovir. In the second cluster, lung and kidney recipients both developed HSV-2 viremia that was successfully treated with antiviral therapy. Genotyping of all HSV-2–positive samples showed 100% sequence homology for three recipients. Conclusions: Donor-derived HSV infection affected two clusters of recipients because of transplantation of organs from a prior organ recipient. HSV should be considered as a possible cause of illness in febrile SOT recipients in the immediate post-transplant period and may cause disseminated disease and re-infection in HSV-2–seropositive recipients. Testing of HSV serology and prophylaxis may be considered in SOT recipients not receiving cytomegalovirus prophylaxis.

KW - allograft re-use

KW - donor-derived infection

KW - herpes simplex virus hepatitis

KW - transplantation

UR - http://www.scopus.com/inward/record.url?scp=85030482942&partnerID=8YFLogxK

U2 - 10.1111/tid.12739

DO - 10.1111/tid.12739

M3 - Article

VL - 19

JO - Transplant Infectious Disease

JF - Transplant Infectious Disease

SN - 1398-2273

IS - 5

M1 - e12739

ER -