Coccidioidomycosis in healthy persons evaluated for liver or kidney donation.
Coccidioidomycosis is a fungal infection caused by Coccidioides species endemic to the southwestern United States, where it poses unique challenges for transplant recipients. Donor-derived coccidioidomycosis has been documented, but its risk of transmission is not known. We prospectively screened 568 healthy persons requesting evaluation for possible liver or kidney donation. Twelve (2.1%) of the 568 donor candidates were seropositive (11 initially and 1 with seroconversion and symptomatic illness within 1 week after negative screening). Three of these 12 patients proceeded to kidney donation, and a fourth patient proceeded to liver donation. None of the 4 transplant recipients received special coccidioidal prophylaxis, although all were administered fluconazole according to standard antifungal prophylaxis protocols. At follow-up (7-54 months), no coccidioidomycosis was identified in any recipient. The prevalence of coccidioidal antibodies was low among potential organ donor candidates, but the risk of donor-derived coccidioidomycosis remains unknown and further study is warranted.
Blair
J E
JE
Division of Infectious Diseases, Mayo Clinic, Scottsdale, AZ 85259, USA. Blair.Janis@mayo.edu
Mulligan
D C
DC
D000328:Adult; D000908:Antibodies, Fungal / Q000097:blood; D003045:Coccidioides / Q000276:immunology*; D003047:Coccidioidomycosis / Q000097:blood / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects; D016036:Seroepidemiologic Studies; D014481:United States / Q000453:epidemiology
D000908:Antibodies, Fungal