Challenging boundaries: Organ transplants from donors with Listeria central nervous system infections

Am J Transplant. 2024 Jul;24(7):1289-1294. doi: 10.1016/j.ajt.2024.02.025. Epub 2024 Feb 29.

Abstract

Pretransplant mortality rates in the US remain high and are connected to effective organ donation and utilization. Thus, there is a need to maximize the utilization of available donors. In some cases, this has been safely achieved using organs from donors with infectious complications. For example, several studies describe the use of organs from donors with bacterial meningitis due to pathogens such as Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenza, and Escherichia coli, with good outcomes. Listeria is an aerobic and facultatively anaerobic, nonspore-forming, Gram-positive rod that can affect the central nervous system, causing meningitis and meningoencephalitis. Due to its virulence, ability to cause intracellular infection, and lack of clinical data, people dying with listeria may not be evaluated for organ donation, may not have organs recovered, or may have their organs recovered but not transplanted. Herein, we describe the outcomes of 7 solid organ transplant recipients who received organs from 2 donors with Listeria monocytogenes central nervous system infection.

Keywords: donor evaluation; donor-derived; expanding the donor pool; organ utilization.

MeSH terms

  • Adult
  • Aged
  • Central Nervous System Infections / microbiology
  • Female
  • Humans
  • Listeria monocytogenes* / isolation & purification
  • Listeriosis / microbiology
  • Male
  • Middle Aged
  • Organ Transplantation* / adverse effects
  • Prognosis
  • Tissue Donors*
  • Tissue and Organ Procurement