Kidney Recipient Dies After Transplant From Organ Donor Who Had Rabies
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> A man died of rabies after getting a kidney transplant from another man who died of the virus
Sequence 1:
Day 0) Donor contributes kidney to donee
Day 10) Donor dies of rabies
Day 15) Donee dies of rabies
Sequence 2 (the incident sequence)
Day 0) Donor shows symptoms of rabies (undiagnosed)
Day 2) Donor dies of rabies (diagnosed as heart failure)
Day 2+?) Donor's kidney is installed in donee
Day N) Donee dies from rabies
Day N+M) Donor's death is reevaluted and rabies is diagnosed
FTA
> About five weeks later, the man started to hallucinate, have trouble walking and swallowing, and had a stiff neck, according to the C.D.C. report.
> Two days after his symptoms started, he collapsed of what was presumed to be a heart attack, the report said. The man was unresponsive and taken to a hospital, where he died.
> Several of his organs were donated, including his left kidney.
Most organs come from from people, usually braindead, who are definitely going to die, but you have days or at least hours before the body actually loses the fight. And even then the extraction process needs to be started quickly, because in the process of dieing the body will, as it's losing blood, ie. power and oxygen, one-by-one cut off blood flow from organs to try to keep the heart, lungs and brain alive. Most organs that have had their blood flow cut off by the body can't be transplanted, so extraction needs to happen before that point.
So that was probably the case here.
> The three patients’ grafts were removed, and one tested positive for rabies, the doctors said. None of the three patients had symptoms of rabies, but they were being treated with preventive drugs, the report said.¶ Since 1978, four organ donors have passed rabies to 13 organ recipients, the report said. Of the 13 recipients, six who received treatment for rabies survived. The seven others, who did not receive treatment, died.
Four of those seven were in an incident from May 2004, which you can read about here: <https://www.nejm.org/doi/full/10.1056/NEJMoa043018>
Not exactly a sentence you would hope to hear...
People seem to think that the TV doctor habits of testing the most out-there diagnoses possible until you get a positive hit are normal in the real world. They're not. Especially not with medical insurer's "advice" now being required for everything.
ONLY?! Rabies cases are really uncommon! I’m seeing 17 in the us from 2015-2024. Even assume double or triple the rates in earlier decades and, what, maybe 200 since 1978? 2-4% chance a given person who dies of rabies has their organs given to someone else? That’s an order of magnitude higher than I’d have guessed. WTF.
Further, rabies incubation is highly variable - symptoms may not appear for years.
Which also suggests perhaps it is slightly more common than data suggests
[1] https://www.cdc.gov/mmwr/volumes/74/wr/mm7439a1.htm
I thought rabies had to be considered for any interaction with a wild animal. For one showing atypical behavior, the indication is that much stronger.
I hope that radiation killed all (if any) viruses...