Fatal pneumonia caused by Panton-Valentine Leucocidine-positive methicillin-resistant Staphylococcus aureus (PVL-MRSA) transmitted from a healthy donor in living-donor liver transplantation

Transplantation. 2006 Jan 15;81(1):121-4. doi: 10.1097/01.tp.0000187886.18720.8a.

Abstract

Severe infections are the most dangerous complications in liver transplantation and their prevention is one of the major goals. A 60-year-old Saudi-Arabian female with decompensated hepatitis C liver cirrhosis received a right-lobe liver graft from her healthy daughter. After 9 days, the patient developed a rapidly progressive necrotizing pneumonia that was fatal in spite of extracorporal lung assist. The pneumonia was due to a Panton-Valentine Leucocidine-positive (PVL) methicillin-resistant Staphylococcus aureus (MRSA), or "community-acquired" MRSA, that had not been detectable in the patient preoperatively. The same strain of PVL-MRSA could be demonstrated in the nares of the asymptomatic donor, but not of other relatives, patients, or medical staff. These findings strongly suggest transmission of PVL-MRSA from the donor to the recipient. This case demonstrates a previously unknown, and potentially fatal, risk in living-donor liver transplantation: transmission of a severe infection from a healthy donor to the recipient.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Health*
  • Humans
  • Liver Transplantation*
  • Living Donors*
  • Methicillin Resistance*
  • Middle Aged
  • Pneumonia, Staphylococcal / diagnostic imaging
  • Pneumonia, Staphylococcal / microbiology*
  • Pneumonia, Staphylococcal / transmission*
  • Radiography
  • Staphylococcus aureus / physiology*
  • Treatment Failure