Deaths from rodent virus raise need for tracking system

Providence, RI After the deaths of seven people from a virus transmitted through organ donation in the past two years, authorities are recommending that a tracking system be put in place to monitor patients following transplantation, and until then, physicians should be more vigilant in looking for signs of infection transmitted through transplantation.

The cases and subsequent recommendations are outlined in the current issue of the New England Journal of Medicine.

The recommendations stem from two separate incidents in which lymphocytic choriomeningitis virus (LCMV), carried by household rodents, was transmitted through organ donation. In one incident in 2003, four patients in Wisconsin died after seemingly contracting LCMV from the same donor. In 2005, three of four patients who received organs from a common donor died at hospitals in Rhode Island and Massachusetts from LCMV. The fourth recipient survived following treatment. Patients in both incidents died between nine days and 2 months after transplantation.

"The only way we discovered this virus is because we had two kidney recipients in the same hospital who were rapidly deteriorating. There currently is no rapid way to find out how other transplant patients are doing. Physicians should be able to quickly get an update on other organ recipients so they can make a real-time diagnosis," says lead author Staci A. Fischer, MD, a physician in infectious diseases for transplant services at Rhode Island Hospital, who first alerted authorities to a potential virus when two kidney transplant patients became gravely ill.

The authors also point out that screening procedures did not detect the virus in the two organ donors, even when tests were performed after transplantation, and that the strains of the virus were different in the two incidents, requiring more sophisticated testing. Donor screenings detect certain transmitted illnesses such as syphilis, HIV, and hepatitis B and C. But

Contact: Nicole Gustin

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