In a rare and tragic incident, a man passed away from rabies following a kidney transplant from a donor who likely contracted the virus after being scratched by a skunk. This unique case was detailed in a report by the Centers for Disease Control and Prevention (CDC) in the United States, marking only the fourth instance of rabies transmission through transplantation in the country in 50 years. The transplant took place at a hospital in Ohio in December 2024.
The recipient of the kidney began experiencing symptoms such as tremors, weakness, confusion, and urinary incontinence five weeks after the surgery. His condition deteriorated rapidly, leading to hospitalization due to fever and respiratory distress, ultimately resulting in his passing.
Investigations revealed the presence of the virus in the recipient’s saliva and brain tissue. Despite the patient having no direct contact with animals, the focus turned to the origin of the donated kidney. The donor, who hailed from Idaho, had succumbed to rabies after a skunk scratch on his property. The man had disclosed this incident during the donor assessment.
Family members recounted the encounter where the donor defended a kitten from the skunk’s aggressive behavior, resulting in a scratch to his shin. Subsequently, the donor displayed symptoms of confusion, hallucinations, difficulty swallowing, and walking before his untimely demise.
Further testing on the donor initially showed no signs of rabies. However, upon the recipient’s illness, more thorough examination revealed the presence of the virus in kidney tissue samples. Investigators concluded that the donor had indeed died from rabies and transmitted the virus through the kidney transplant.
The CDC emphasized the rarity of such transmission events due to the low occurrence of rabies in humans in the U.S. and the intricate detection methods required. Following the incident, other tissues from the donor were traced, leading to precautionary measures with cornea graft recipients receiving Post-Exposure Prophylaxis.
It was highlighted that rabies is typically not screened for during organ donor testing, relying on family accounts of potential exposure. Dr. Lara Danziger-Isakov from Cincinnati Children’s Hospital Medical Centre reiterated the exceptional nature of the case, underscoring the minimal overall risk associated with such occurrences.
