Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cra. 98 #18-49, Cali, Colombia.
Rutgers New Jersey Medical School, Trinitas Regional Medical Center, 225 Williamson St, Elizabeth, NJ, USA.
Trans R Soc Trop Med Hyg. 2019 Aug 1;113(8):431-436. doi: 10.1093/trstmh/trz024.
Dengue virus can infect humans through vectorial and non-vectorial transmission. Classically, non-vectorial transmission has been related to vertical transmission and health care-associated infections, but recently transmission to solid organ and bone marrow recipients has been reported. We performed a scoping review of the available literature searching for evidence on screening for dengue in potential organ donors and the use of these infected organs. From 372 unique records identified, 17 were eligible to be included in our scoping study. After applying inclusion and exclusion criteria, three studies were included. These studies described a total of six patients from India (two case reports; n=2) and Colombia (one case series; n=4). Three patients received a liver, two received a kidney and one had a heart transplant. The onset of symptoms occurred in the first week after transplant in all cases and all experienced fever as the primary symptom. All patients presented thrombocytopenia with a platelet count <50 000. None of the patients developed graft rejection. However, four patients presented graft complications. No recipient deaths occurred. There is not a strong recommendation for dengue screening of donors in transplantation guidelines, but in endemic areas, physicians should be aware of this type of transmission before transplantation.
登革热病毒可通过媒介传播和非媒介传播感染人类。传统上,非媒介传播与垂直传播和与卫生保健相关的感染有关,但最近也有报道称可传播给实体器官和骨髓接受者。我们对现有文献进行了范围界定审查,以寻找有关对潜在器官供体进行登革热筛查以及使用这些受感染器官的证据。在确定的 372 份独特记录中,有 17 份符合纳入我们范围界定研究的标准。在应用纳入和排除标准后,有三项研究被纳入。这些研究共描述了来自印度的 6 名患者(2 份病例报告;n=2)和哥伦比亚的 1 名患者(1 例病例系列;n=4)。3 名患者接受了肝脏移植,2 名患者接受了肾脏移植,1 名患者接受了心脏移植。所有病例均在移植后第一周出现症状,所有患者均以发热为主要症状。所有患者均出现血小板计数<50000 的血小板减少症。没有患者发生移植物排斥反应。但是,有 4 名患者出现了移植物并发症。没有受者死亡。在移植指南中,对供体进行登革热筛查没有强烈的建议,但在流行地区,医生在移植前应意识到这种类型的传播。