Outcomes in solid organ transplant recipients receiving organs from a donor with Fusarium solani species complex meningitis

• DOI: 10.1111/tid.14331
• Publication Date: 2024-07-16T15:42:53Z
• Authors: Isabel S. Griffin; Dallas J. Smith; Pallavi Annambhotla; Jeremy A. W. Gold; Luis Ostrosky‐Zei...; Carol A. Kauffman; Lalitha Gade; Anastasia Litvint...; Daniel ZP Friedman; Angie G Nishio Lucar; Tarina C Parpia; Joshua Lieberman; Janet Bujan; Julie Corkrean; Mukul K. Divatia; Kevin Grimes; Jiejian Lin; Constance Mobley; Mary R. Schwartz; Bashar Hannawi; Anne Malilay; Anne O'Boye; Jeffrey Lysne; Mrinalini Venkata...; Hayley Heckmann; Venice Servellita; Charles Chiu; Sridhar V. Basava...
• Keywords: 0301 basic medicine; 0303 health sciences

AbstractBackgroundFive organs (heart, right lung, liver, right, and left kidneys) from a deceased patient were transplanted into five recipients in four US states; the deceased patient was identified as part of a healthcare‐associated fungal meningitis outbreak among patients who underwent epidural anesthesia in Matamoros, Mexico.MethodsAfter transplant surgeries occurred, Fusarium solani species complex, a fungal pathogen with a high case‐mortality rate, was identified in cerebrospinal fluid from the organ donor by metagenomic next‐generation sequencing (mNGS) and fungal‐specific polymerase chain reaction and in plasma by mNGS.ResultsFour of five transplant recipients received recommended voriconazole prophylaxis; four were monitored weekly by serum (1‐3)‐β‐d‐glucan testing. All five were monitored for signs of infection for at least 3 months following transplantation. The liver recipient had graft failure, which was attributed to an etiology unrelated to fungal infection. No fungal DNA was identified in sections of the explanted liver, suggesting that F. solani species complex did not contribute to graft failure. The remaining recipients experienced no signs or symptoms suggestive of fusariosis.ConclusionAntifungal prophylaxis may be useful in preventing donor‐derived infections in recipients of organs from donors that are found to have Fusarium meningitis. image