title: Asymptomatic transmission of Treponema pallidum (syphilis) through deceased donor liver transplantation.
abstract: A 55-year-old woman underwent liver transplantation (LT) with a graft from a deceased donor. Mandatory pre-donation investigations showed positive syphilis serology that was available only after the transplant, with high Treponema pallidum particle agglutination assay titer compatible with donor syphilis infection. Despite the institution of appropriate post-exposure prophylaxis, the recipient demonstrated latent seroconversion; however, liver graft function improved without evidence of syphilitic hepatitis or other manifestations of the disease. Through this first reported case of asymptomatic transmission of syphilis following LT, we highlight the investigations and treatment strategies for donor-derived syphilis in liver transplant recipients. This report supplements the existing limited evidence on safe use of infected grafts from syphilitic donors through appropriate post-exposure prophylaxis.
authors.affiliation: The Liver Unit, Department of Microbiology, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: L
authors.initials: L
authors.lastname: Tariciotti
authors.forename: I
authors.initials: I
authors.lastname: Das
authors.forename: L
authors.initials: L
authors.lastname: Dori
authors.forename: M T P R
authors.initials: MT
authors.lastname: Perera
authors.forename: S R
authors.initials: SR
authors.lastname: Bramhall
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008099:Liver / Q000382:microbiology*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013587:Syphilis / Q000635:transmission*; D013588:Syphilis Serodiagnosis; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D014210:Treponema pallidum / Q000302:isolation & purification*