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A Cluster of Fatal Tick-borne Encephalitis Virus Infection in Organ Transplant Setting.
J Infect Dis. 2017 03 15; 215(6):896-901.JI

Abstract

Background

Tick-borne encephalitis virus (TBEV) infection has become a major health problem in Europe and is currently a common cause of viral brain infection in many countries. Encephalitis in transplant recipients, althrough rare, is becoming a recognized complication. Our study provides the first description of transmission of TBEV through transplantation of solid organs.

Methods

Three patients who received solid organ transplants from a single donor (2 received kidney, and 1 received liver) developed encephalitis 17-49 days after transplantation and subsequently died. Blood and autopsy tissue samples were tested by next-generation sequencing (NGS) and reverse transcription polymerase chain reaction (RT-PCR).

Results

All 3 recipients were first analyzed in autopsy brain tissue samples and/or cerebrospinal fluid by NGS, which yielded 24-52 million sequences per sample and 9-988 matched TBEV sequences in each patient. The presence of TBEV was confirmed by RT-PCR in all recipients and in the donor, and direct sequencing of amplification products corroborated the presence of the same viral strain.

Conclusions

We demonstrated transmission of TBEV by transplantation of solid organs. In such a setting, TBEV infection may be fatal, probably due to pharmacological immunosuppression. Organ donors should be screened for TBEV when coming from or visiting endemic areas.

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Authors+Show Affiliations

Lipowski D
Department of Infectious Diseases, Warsaw Medical University, Warsaw, Poland.
Popiel M
Department of Immunopathology of Infectious and Parasitic Diseases, Warsaw Medical University, Warsaw, Poland.
Perlejewski K
Department of Immunopathology of Infectious and Parasitic Diseases, Warsaw Medical University, Warsaw, Poland.
Nakamura S
Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan.
Bukowska-Osko I
Department of Immunopathology of Infectious and Parasitic Diseases, Warsaw Medical University, Warsaw, Poland.
Rzadkiewicz E
Department of Infectious Diseases, Warsaw Medical University, Warsaw, Poland.
Dzieciatkowski T
Department of Microbiology, Warsaw Medical University, Warsaw, Poland.
Milecka A
Department of General and Endocrine Surgery and Transplantation Medical University of Gdansk, Gdansk, Poland.
Wenski W
Intensive Care Unit, Regional Hospital, Elblag, Poland.
Ciszek M
Department of Immunology, Warsaw Medical University, Warsaw, Poland.
Debska-Slizien A
Department of Nephrology, Transplantation and Internal Diseases, Gdansk Medical University, Gdansk, Poland.
Ignacak E
Department of Nephrology, Kraków Medical University Hospital, Poland.
Cortes KC
Department of Immunopathology of Infectious and Parasitic Diseases, Warsaw Medical University, Warsaw, Poland.
Pawelczyk A
Department of Immunopathology of Infectious and Parasitic Diseases, Warsaw Medical University, Warsaw, Poland.
Horban A
Department of Infectious Diseases, Warsaw Medical University, Warsaw, Poland.
Radkowski M
Department of Immunopathology of Infectious and Parasitic Diseases, Warsaw Medical University, Warsaw, Poland.
Laskus T
Department of Immunopathology of Infectious and Parasitic Diseases, Warsaw Medical University, Warsaw, Poland.

MeSH

AdultAutopsyBrainDonor SelectionEncephalitis Viruses, Tick-BorneEncephalitis, Tick-BorneFatal OutcomeHumansMaleMiddle AgedOrgan TransplantationPolandPostoperative ComplicationsRNA, ViralSequence Analysis, RNATissue Donors

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

28453842

Citation

Lipowski, Dariusz, et al. "A Cluster of Fatal Tick-borne Encephalitis Virus Infection in Organ Transplant Setting." The Journal of Infectious Diseases, vol. 215, no. 6, 2017, pp. 896-901.
Lipowski D, Popiel M, Perlejewski K, et al. A Cluster of Fatal Tick-borne Encephalitis Virus Infection in Organ Transplant Setting. J Infect Dis. 2017;215(6):896-901.
Lipowski, D., Popiel, M., Perlejewski, K., Nakamura, S., Bukowska-Osko, I., Rzadkiewicz, E., Dzieciatkowski, T., Milecka, A., Wenski, W., Ciszek, M., Debska-Slizien, A., Ignacak, E., Cortes, K. C., Pawelczyk, A., Horban, A., Radkowski, M., & Laskus, T. (2017). A Cluster of Fatal Tick-borne Encephalitis Virus Infection in Organ Transplant Setting. The Journal of Infectious Diseases, 215(6), 896-901. https://doi.org/10.1093/infdis/jix040
Lipowski D, et al. A Cluster of Fatal Tick-borne Encephalitis Virus Infection in Organ Transplant Setting. J Infect Dis. 2017 03 15;215(6):896-901. PubMed PMID: 28453842.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Cluster of Fatal Tick-borne Encephalitis Virus Infection in Organ Transplant Setting. AU - Lipowski,Dariusz, AU - Popiel,Marta, AU - Perlejewski,Karol, AU - Nakamura,Shota, AU - Bukowska-Osko,Iwona, AU - Rzadkiewicz,Ewa, AU - Dzieciatkowski,Tomasz, AU - Milecka,Anna, AU - Wenski,Wojciech, AU - Ciszek,Michal, AU - Debska-Slizien,Alicja, AU - Ignacak,Ewa, AU - Cortes,Kamila Caraballo, AU - Pawelczyk,Agnieszka, AU - Horban,Andrzej, AU - Radkowski,Marek, AU - Laskus,Tomasz, PY - 2016/09/30/received PY - 2017/01/17/accepted PY - 2017/4/29/entrez PY - 2017/4/30/pubmed PY - 2017/7/1/medline KW - encephalitis KW - transplantation KW - TBEV SP - 896 EP - 901 JF - The Journal of infectious diseases JO - J Infect Dis VL - 215 IS - 6 N2 - Background: Tick-borne encephalitis virus (TBEV) infection has become a major health problem in Europe and is currently a common cause of viral brain infection in many countries. Encephalitis in transplant recipients, althrough rare, is becoming a recognized complication. Our study provides the first description of transmission of TBEV through transplantation of solid organs. Methods: Three patients who received solid organ transplants from a single donor (2 received kidney, and 1 received liver) developed encephalitis 17-49 days after transplantation and subsequently died. Blood and autopsy tissue samples were tested by next-generation sequencing (NGS) and reverse transcription polymerase chain reaction (RT-PCR). Results: All 3 recipients were first analyzed in autopsy brain tissue samples and/or cerebrospinal fluid by NGS, which yielded 24-52 million sequences per sample and 9-988 matched TBEV sequences in each patient. The presence of TBEV was confirmed by RT-PCR in all recipients and in the donor, and direct sequencing of amplification products corroborated the presence of the same viral strain. Conclusions: We demonstrated transmission of TBEV by transplantation of solid organs. In such a setting, TBEV infection may be fatal, probably due to pharmacological immunosuppression. Organ donors should be screened for TBEV when coming from or visiting endemic areas. SN - 1537-6613 UR - https://www.unboundmedicine.com/medline/citation/28453842/full_citation L2 - https://academic.oup.com/jid/article-lookup/doi/10.1093/infdis/jix040 DB - PRIME DP - Unbound Medicine ER -