Transmission of Babesia microti Parasites by Solid Organ Transplantation

• Published in: Emerging infectious diseases Vol. 22; no. 11; pp. 1869 - 1876
• Main Authors: Brennan, Meghan B, Herwaldt, Barbara L, Kazmierczak, James J, Weiss, John W, Klein, Christina L, Leith, Catherine P, He, Rong, Oberley, Matthew J, Tonnetti, Laura, Wilkins, Patricia P, Gauthier, Gregory M
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01-11-2016; Centers for Disease Control and Prevention
• Subjects: Adult; Aged; Anemia; Babesia microti; Babesia microti - genetics; Babesia microti - immunology; babesiosis; Babesiosis - diagnosis; Babesiosis - drug therapy; Babesiosis - parasitology; Babesiosis - transmission; Biomarkers; Blood donors; Blood Transfusion; Disease transmission; Erythrocytes - parasitology; Erythrocytes - pathology; Health aspects; human babesiosis; Humans; Kidney Transplantation - adverse effects; Kidneys; Male; organ transplantation; Organ Transplantation - adverse effects; parasites; Parasites by Solid Organ Transplantation; protozoa; Risk factors; Time Factors; Tissue Donors; Tomography, X-Ray Computed; Transmission of; Transplantation; Transplantation, Homologous; Maryland; Minnesota; Wisconsin; United States; Babesia microti; kidney transplant; Minnesota; babesiosis; protozoa; erythrocyte transfusion; human babesiosis; vector-borne infections; organ transplantation; parasites; tissue donor; Wisconsin; hemolytic anemia
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid2211.151028

Babesia microti, an intraerythrocytic parasite, is tickborne in nature. In contrast to transmission by blood transfusion, which has been well documented, transmission associated with solid organ transplantation has not been reported. We describe parasitologically confirmed cases of babesiosis diagnosed ≈8 weeks posttransplantation in 2 recipients of renal allografts from an organ donor who was multiply transfused on the day he died from traumatic injuries. The organ donor and recipients had no identified risk factors for tickborne infection. Antibodies against B. microti parasites were not detected by serologic testing of archived pretransplant specimens. However, 1 of the organ donor's blood donors was seropositive when tested postdonation and had risk factors for tick exposure. The organ donor probably served as a conduit of Babesia parasites from the seropositive blood donor to both kidney recipients. Babesiosis should be included in the differential diagnosis of unexplained fever and hemolytic anemia after blood transfusion or organ transplantation.