Geographic Infections/Transplant Tourism And Donor-Derived Infection:

Suggestions For Better Donor Screening

Camille N. Kotton, Boston, MA, USA

International migration is occurring at higher rates than ever before. The majority of the migration is occurring into countries where organ transplantation occurs, occasionally introducing unexpected and sometimes bewildering infections with potential mortal outcomes into this vulnerable immunocompromised population. Infections of specific concern include Plasmodium species (malaria), Trypanosoma cruzi (the etiologic agent of Chagas disease), Strongyloides stercoralis, geographic fungal infections (i.e., coccidiomycosis and histoplasmosis), tuberculosis, multi-drug-resistant bacteria, rabies, West Nile virus, and other arboviruses. Transplant tourism, where recipients or donors travel to other regions for purposes of organ transplant, introduces additional risks for acquisition of geographic and endemic infections, and has been shown to convey high rates of morbidity and mortality. Transplant clinicians should be aware of the risk of transmission and/or reactivation of such infections, and should be familiar with screening methods of donors to reduce or prevent such infections.