02665nas a2200313   4500008004500000022001400045245008400059210006900143260002300212300000600235490000700241520164900248653001001897653001801907653001101925653000701936653004901943653004301992653000902035653002202044653003102066653003102097653004902128653001802177653003802195100001302233700001502246856009002261       2005                        Engldsh    a1527-646500aTransmission of rabies virus from an organ donor to four transplant recipients.0 aTransmission of rabies virus from an organ donor to four transpl  aUnited StatescOct  a50 v113 aBACKGROUND: In 2004, four recipients of kidneys, a liver, and an arterial segment from a common organ donor died of encephalitis of an unknown cause. METHODS: We reviewed the medical records of the organ donor and the recipients. Blood, cerebrospinal fluid, and tissues from the recipients were tested with a variety of assays and pathological stains for numerous causes of encephalitis. Samples from the recipients were also inoculated into mice. RESULTS: The organ donor had been healthy before having a subarachnoid hemorrhage that led to his death. Encephalitis developed in all four recipients within 30 days after transplantation and was accompanied by rapid neurologic deterioration characterized by agitated delirium, seizures, respiratory failure, and coma. They died an average of 13 days after the onset of neurologic symptoms. Mice inoculated with samples from the affected patients became ill seven to eight days later, and electron microscopy of central nervous system (CNS) tissue demonstrated rhabdovirus particles. Rabies-specific immunohistochemical and direct fluorescence antibody staining demonstrated rabies virus in multiple tissues from all recipients. Cytoplasmic inclusions consistent with Negri bodies were seen in CNS tissue from all recipients. Antibodies against rabies virus were present in three of the four recipients and the donor. The donor had told others of being bitten by a bat. CONCLUSIONS: This report documenting the transmission of rabies virus from an organ donor to multiple recipients underscores the challenges of preventing and detecting transmission of unusual pathogens through transplantation.10aAdult10aFatal Outcome10aHumans10aIM10aLiver Transplantation / ae [Adverse Effects]10aLiver Transplantation / mo [Mortality]10aMale10aPatient Selection10aRabies / ep [Epidemiology]10aRabies / tm [Transmission]10aRabies virus / ip [Isolation & Purification]10aTissue Donors10aUnited States / ep [Epidemiology]1 aKusne, S1 aSmilack, J  uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=med4&AN=16184559