Transmission of Cryptococcus neoformans by Organ Transplantation.

BACKGROUND: This article describes transmission of Cryptococcus neoformans by solid organ transplantation.

METHODS: We reviewed medical records and performed molecular genotyping of isolates to determine potential for donor transmission of Cryptococcus.

RESULTS: Cryptococcosis was diagnosed in 3 recipients of organs from a common donor with an undifferentiated neurologic condition at the time of death. Cryptococcal meningoencephalitis was later diagnosed in the donor at autopsy. The liver and 1 kidney recipient developed cryptococcemia and pneumonia and the other kidney recipient developed cryptococcemia and meningitis; 2 patients recovered with prolonged antifungal therapy. We tested 4 recipient isolates with multilocus sequence typing and found they had identical alleles.

CONCLUSIONS: Our investigation documents the transmission of Cryptococcus neoformans by organ transplantation. Evaluation for cryptococcosis in donors with unexplained neurologic symptoms should be strongly considered.