Solid Organ Transplant–Transmitted Tuberculosis Linked to a Community Outbreak — California, 2015

Abstract

© 2017, Department of Health and Human Services. All rights reserved. What is already known about this topic? Donor-derived tuberculosis (TB) is a rare but important complication of solid organ transplantation. When donor-derived TB disease is identified in an organ recipient, other patients who received organs from the same donor should be evaluated and, when indicated, treated for TB infection or disease. What is added by this report? This report describes a case of donor-derived TB disease and illustrates some limitations in determining the TB status of organ donors through medical evaluation or interviewing next-of-kin. This report also describes how the organ recipient’s TB genotyping results helped link the recipient with patients within an ongoing TB outbreak. What are the implications for public health practice? Clinicians and local health departments (LHDs) should assess the likelihood of donor-derived transmission in organ recipients who develop TB disease. State TB programs can help LHDs obtain and analyze TB genotyping results of organ recipients with TB disease for evidence of possible donor-derived TB. Detection and investigation of suspected donor-derived TB are aided by communication among organ procurement organizations, clinicians, and public health programs at the local, state, and federal level. Retrieving the transplant donor’s medical records from settings such as jails and prisons might augment the predonation TB risk assessment.