Abstract

BackgroundDonor-derived human parvovirus B19 (B19V) infections are rarely reported. Thus, its incidence in kidney transplantation is still unknown due to lack of surveillance studies. Similarly, whether the donor needs to be routinely screened for B19V and whether the kidneys from those with B19V DNAemia could be accepted also remain unknown.MethodsThis retrospective study aims to evaluate the donor-derived B19V infections occurring in 823 living and 1,225 deceased donor kidney transplantations from January 2016 to December 2020. The serum viral load of living donors and their corresponding recipients was evaluated before and after transplantation. Meanwhile, for the deceased donor kidney transplantation, the serum viral load of recipients was only tested after transplantation; if recipients of a deceased donor subsequently developed B19V infection, the serum viral load of recipients and their corresponding donors before transplantation would then be further traced.ResultsA total of 15 living donors were B19V DNAemia positive before the donation, of which B19V DNAemia occurred in three corresponding recipients. In deceased donor kidney transplantation, DNAemia occurred simultaneously in 18 recipients and their corresponding nine donors. A progressive decline in hemoglobin and reticulocyte count could be observed in one living donor recipient and other 11 deceased donor recipients, which were all well controlled by treatment eventually.ConclusionThe incidence of donor-derived B19V infection was 0.4% and 1.5% in living and deceased kidney transplantations, respectively. B19V was seemingly unnecessary to be routinely screened for the donor. Moreover, kidneys of the donors with B19V infection were acceptable.

Highlights

  • Infection transmission from donor to recipient is one of the primary causes that affect early survival rate of recipients after transplantation (Kirchner and Pruett, 2016)

  • All 15 donors had no clinical manifestations of B19V infection such as fever, flu-like symptoms, weakness, dyspnea, arthralgias, rashes, and orthostatic hypotension during the follow-up period from 1 to 34 months

  • Hemoglobin and platelet counts of these three corresponding donors were both normal, and only two donors had mild leukopenia before donation. These three recipients had no clinical manifestations of B19V infection but with low-level DNAemia after transplantation

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Summary

Introduction

Infection transmission from donor to recipient is one of the primary causes that affect early survival rate of recipients after transplantation (Kirchner and Pruett, 2016). The use of intensive immunosuppressive drugs in the early stage after transplantation may amplify the risk of infection carried by the donor organ (Fishman and Grossi, 2014). Many serious donor-derived infections caused by virus, such as rabies, West Nile virus, and lymphocytic choriomeningitis virus (Fischer, 2008), fall into unexpected infections category, with human parvovirus B19 (B19V) infections being part of this category. Donor-derived human parvovirus B19 (B19V) infections are rarely reported. Whether the donor needs to be routinely screened for B19V and whether the kidneys from those with B19V DNAemia could be accepted remain unknown

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