Solid organ donation after death from listeria encephalitis: A case report.


Journal

Transplant infectious disease : an official journal of the Transplantation Society
ISSN: 1399-3062
Titre abrégé: Transpl Infect Dis
Pays: Denmark
ID NLM: 100883688

Informations de publication

Date de publication:
Jun 2020
Historique:
received: 26 02 2020
revised: 06 04 2020
accepted: 12 04 2020
pubmed: 18 4 2020
medline: 4 2 2021
entrez: 18 4 2020
Statut: ppublish

Résumé

Despite organ shortage, organs from donors with listeria infections have been discarded for transplantation. We present the first-reported case of liver transplantation following listeria encephalitis. The patient was admitted with progressing neurological symptoms after an episode of gastroenteritis. Rhombo-encephalitis was diagnosed, and Listeria monocytogenes was found to be the causative pathogen. Despite proper antibiotic treatment and rapid clearance of bacteremia, he continued to deteriorate and became brain dead, after which organ donation was performed. At procurement, he had been treated with amoxicillin for 9 days. The recipient was treated with pipercillin/tazobactam for 21 days. Besides an anastomotic biliary stricture, necessitating endoscopic dilatation and stenting, further clinical course was uneventful and she is doing well eleven months post-transplant. Our case suggests that listeria encephalitis is not an absolute contra-indication to solid organ donation. We suggest that donors should be treated with adequate antibiotics for at least 48h prior to procurement and advocate confirmation of sterile blood cultures as a prerequisite for donation. According to listeriosis guidelines, we suggest that the recipient should be treated with targeted antibiotics for at least 2 weeks. The risk of transmission should, however, always be balanced carefully against the suspected waiting list mortality.

Identifiants

pubmed: 32303115
doi: 10.1111/tid.13295
doi:

Substances chimiques

Anti-Bacterial Agents 0

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

e13295

Informations de copyright

© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Références

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Auteurs

Thomas Douchy (T)

Department of abdominal transplant surgery, University hospitals Leuven, Leuven, Belgium.

Katrien Lagrou (K)

Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.
Clinical Department of Laboratory Medicine, University hospitals Leuven, Leuven, Belgium.

Ina Jochmans (I)

Department of abdominal transplant surgery, University hospitals Leuven, Leuven, Belgium.
Lab of Abdominal Transplantation, Transplantation Group, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium.

Mauricio Sainz Barriga (M)

Department of abdominal transplant surgery, University hospitals Leuven, Leuven, Belgium.
Lab of Abdominal Transplantation, Transplantation Group, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium.

Diethard Monbaliu (D)

Department of abdominal transplant surgery, University hospitals Leuven, Leuven, Belgium.
Lab of Abdominal Transplantation, Transplantation Group, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium.

Jacques Pirenne (J)

Department of abdominal transplant surgery, University hospitals Leuven, Leuven, Belgium.
Lab of Abdominal Transplantation, Transplantation Group, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium.

Yves Debaveye (Y)

Department of Intensive Care Medicine, University hospitals Leuven, Leuven, Belgium.

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