title: Donor-derived Strongyloides stercoralis infection in solid organ transplant recipients in the United States, 2009-2013.
abstract: Infection with Strongyloides stercoralis is typically asymptomatic in immunocompetent hosts, despite chronic infection. In contrast, immunocompromised hosts such as solid organ transplant recipients are at risk for hyperinfection syndrome and/or disseminated disease, frequently resulting in fatal outcomes. Infection in these recipients may result from reactivation of latent infection or infection through transmission from an infected donor. We describe the Centers for Disease Control and Prevention's experience with seven clusters of donor-derived infection from 2009 to 2013. Six of the seven (86%) donors were born in Latin America; donor screening was not performed prior to organ transplantation in any of these investigations. Eleven of the 20 (55%) organ recipients were symptomatic, two of whom died from complications of strongyloidiasis. We also describe the New York Organ Donor Network (NYODN) experience with targeted donor screening from 2010 to 2013. Of the 233 consented potential donors tested, 10 tested positive for Strongyloides antibody; and 18 organs were transplanted. The majority (86%) of the donors were born in Central or South America. Fourteen recipients received prophylaxis after transplantation; no recipients developed strongyloidiasis. The NYODN experience provides evidence that when targeted donor screening is performed prior to transplantation, donor-derived infection can be averted in recipients.
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control Prevention, Atlanta, GA.
authors.forename: F A
authors.initials: FA
authors.lastname: Abanyie
authors.forename: E B
authors.initials: EB
authors.lastname: Gray
authors.forename: K W
authors.initials: KW
authors.lastname: Delli Carpini
authors.forename: A
authors.initials: A
authors.lastname: Yanofsky
authors.forename: I
authors.initials: I
authors.lastname: McAuliffe
authors.forename: M
authors.initials: M
authors.lastname: Rana
authors.forename: P V
authors.initials: PV
authors.lastname: Chin-Hong
authors.forename: C N
authors.initials: CN
authors.lastname: Barone
authors.forename: J L
authors.initials: JL
authors.lastname: Davis
authors.forename: S P
authors.initials: SP
authors.lastname: Montgomery
authors.forename: S
authors.initials: S
authors.lastname: Huprikar
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D002487:Centers for Disease Control and Prevention, U.S.; D046148:Donor Selection / Q000379:methods*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation / Q000009:adverse effects; D007843:Latin America; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000150:complications* / Q000453:epidemiology; D014019:Tissue Donors; D066027:Transplant Recipients; D014180:Transplantation; D014481:United States
keywords: donors and donation: donor-derived infections; infection and infectious agents; parasitic