Status of investigation into West Nile infection in organ transplant recipients

Published on: Friday, September 20, 2002

Federal and state officials are vigorously investigating recent cases of possible development of West Nile viral infection among transplant recipients. The Health Resources and Services Administration (HRSA) and the United Network for Organ Sharing (UNOS) want to ensure that transplant professionals, transplant candidates and recipients and the public know the status of these investigations. In addition, we want to provide resource information about West Nile virus to help transplant professionals be aware of its etiology and treatment options. HRSA has additionally issued an Advisory Alert, which is also available on this site.

Two incidents are now under investigation by the Centers for Disease Control and Prevention (CDC). In the first reported case, four recipients developed West Nile viral infection through transplanted organs from a single donor. In the more recently reported case, a liver recipient developed a West Nile infection soon after transplantation.

In each case, it is not yet known whether the organ donor contracted the virus through a mosquito bite or whether the virus was passed through blood transfusions. In the first incident, the organ donor received multiple transfusions prior to death. In the second case, the transplant recipient received transfusions for early post-transplant complications. Testing is still underway to answer these questions.

The risk of acquiring West Nile infection through organ transplantation or blood transfusion is still undetermined but is thought to be low. Clinicians caring for early-term post-transplant recipients with febrile illnesses associated with unexplained encephalitis or meningitis should consider West Nile infection as a possible cause of illness. The resources below provide additional details that may be helpful in assessing this possibility.

The OPTN/UNOS Organ Procurement Organization Committee discussed this issue at its meeting Sept. 9. Given the lack of any current FDA-approved test for the West Nile virus, the committee agreed that for the immediate future, the best course of action is for organ procurement organizations to continue their thorough screening process for all types of infection including the extensive medical and social history, physical examination and medical testing currently in place.

We hope that public reporting of this case, while vital to protecting the public health, does not deter organ or blood donation. These donations save and enhance the lives of countless men, women and children every year. It is important to study this case to determine and minimize the risk of West Nile infection, but the far greater risk is that lives may be lost if public confidence in donation is shaken.

The following Internet-based resources provide additional information about West Nile and will continue to be updated as more becomes known in the ongoing investigations. Thank you for your attention and cooperation.