Unexpected donor-derived infectious transmissions by kidney transplantation: A systematic review

Rashmi Shingde, L. Ines Habachou, Vaishnavi Calisa, Jonathan C. Craig, Allison Tong, Sharon C.–. Chen, Germaine Wong

Research output: Contribution to journalReview articlepeer-review

16 Citations (Scopus)


Background: Unexpected donor-derived transmission of infections is rare, but is associated with significant morbidity and mortality. We aimed to provide an overview of published cases on unexpected infectious transmissions. Methods: We systematically reviewed all published evidence describing any unexpected donor-derived viral, bacterial, fungal, and parasitic infections in kidney transplant recipients. Results: In all, 119 studies (case reports [n = 36], case series [n = 78], cohort studies [n = 2], and case-control studies [n = 3]) involving 139 donors and 207 kidney recipients were included. Donor-derived viral (n = 116, 56.0%) infections were most prevalent, followed by bacterial (32, 15.5%), fungal (32, 15.5%), and parasitic (27, 13.0%) infections. The most commonly reported viral infections were human immunodeficiency virus (HIV) (n = 20, 9.7%), human T-cell lymphotrophic virus (HTLV) (n = 20, 9.7%), and West Nile virus (WNV) (n = 13, 6.3%). The most frequent bacterial infections were caused by Mycobacterium tuberculosis (10, 4.8%) and Pseudomonas aeruginosa (9, 4.3%). Candida species were the most frequent causes of fungal donor-derived infections (8, 3.9%). Toxoplasma gondii accounted for seven (3.4%) cases of transmitted parasitic infections. Patients with rabies experienced the highest probability of recipient death from virus-related complications at 90.0%, within a median time of 2.8 months after transplantation. Conclusion: The frequency of donor-derived infectious transmission appears low in kidney transplantation, with viral transmissions being most commonly reported overall.

Original languageEnglish
Article numbere12851
Number of pages12
JournalTransplant Infectious Disease
Issue number2
Early online date6 Mar 2018
Publication statusPublished - Apr 2018
Externally publishedYes


  • donor outcomes
  • infections
  • kidney transplantation
  • viruses


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