Trasmission of rabies virus from an organ donor to two renal transplant recipients / 中华器官移植杂志

ABSTRACT

Objective To investigate the clinical characteristics and strategy of prophylaxis and treatment of rabies.Methods Two recipients and their donors with rabies were reviewed to confirm the transmission through kidney transplantation.Saliva,urine,and sputum samples from recipients were collected for the detection of rabies virus by reverse transcription PCR (RT-PCR).Results The donor was a 6-year old boy,died of viral encephalitis of unknown cause.His kidneys and corneas were donated for transplantation.Two recipients who received the donor kidneys had neurological symptoms associated with rabies successively.Both of the two recipients died 44 days and 34 days after onset of post-transplant symptoms.Saliva,urine,and sputum samples were positive for rabies virus nucleic acid.The epidemiological investigation revealed that the boy had a history of close contact with his dog.The parents denied the history of animal bites or rabies prophylaxis.Conclusion The rabies virus can be transmitted through organ transplantation.Incubation period of rabies transmitted from donor is shorter than general population and the mortality rate is up to 100％ after onset of symptoms.So,both coordinators and doctors should deeply understand the rabies.The evaluation and supervision of donor derived diseases should be strengthened.The donors should not be donated whenever the rabies is not completely excluded,especially those died of encephalitis of unknown cause.Furthermore,post-exposure prophylaxis of rabies should be administered as soon as possible before onset of symptoms after transplant from a donor with rabies.