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Rare Pneumonia Diagnosed Post Lung-Transplantation In US: Doctor Explains The Link

Can organ transplant cause Legionnaires disease?

Written by saumya pandeyUpdated : September 18, 2023 6:01 PM IST

A lung transplant case has unveiled the presence of Legionella bacteria in the lungs that can cause severe pneumonia. According to the Centers for Disease Control and Prevention (CDC), two people in the US got infected by this bacteria after undergoing a lung transplantation. This has shed some light on the deadly bacteria that are naturally found in freshwater. Two lung transplant recipients in the case involved patients from Pennsylvania who received lung transplants from the same donor, who tragically drowned in a river. The first patient, a woman in her 70s, received a right lung transplant in May 2022. Nine days post-transplant, she exhibited abnormal blood cell counts and acute anaemia. Imaging identified abnormalities in the donor's lung, but she recovered after treatment. The second patient, a man in his 60s, received a left lung transplant from the same donor on the same day. He faced complications, requiring extracorporeal membrane oxygenation and renal replacement therapy. Despite initial recovery, he succumbed approximately six months later to respiratory failure from a mucous plug.

Three other organ recipients (heart, liver, and right kidney) from the same donor did not contract the bacteria. The source of the bacteria was investigated but not found in the hospital's water supply. The donor's exposure to river water may explain different Legionella species in the patients as the bacteria is found in the freshwater.

Legionella bacteria naturally exist in freshwater environments and thrive in warm temperatures. These cases need to be addressed and to prevent the occurrence of Legionnaires disease, effective water management and strict infection control are required. Though solid organ transplantation elevates Legionella risk due to immunosuppression, organ-to-organ transmission has not been previously reported. Prompt identification of infections in transplant recipients is crucial to limit morbidity and mortality.

To avoid such incidents, transplantation procedures should be done by taking more precautions.

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Two People Saved By Lung Transplants From Donor Who Drowned Develop Deadly Water-borne Disease

DOCTORS were shocked to discover two people developed deadly water-borne Legionnaires' disease after receiving lung transplants.

In the first case of its kind, medics said it's likely the bug emerged from the donated lungs themselves, which came from a man who drowned in fresh water.

Two people developed Legionnaires' disease after receiving lung transplantsCredit: Alamy

Legionnaires' is a severe form of pneumonia caused by inhaling the bacteria in small droplets of water or accidentally swallowing water containing Legionella.

The bacteria which causes the infection is found naturally in freshwater but typically grow best in warm water and in warm to hot temperature.

In a report, published by the Centre for Disease Control, researchers said the lungs of a US man in his 30s, who fell into a river and was underwater for more than five minutes, were donated.

His organs were removed seven days after his death, and given to a woman in her 70s and a man in his 60s at the same hospital, both of whom were unnamed.

No one suspected that the lungs had been exposed to Legionella, so were not tested.

Nine days after the transplant, the woman developed anaemia (a lack of iron) and a high white blood cell count, a sign of infection of inflammation.

Further testing revealed she had Legionnaires'. She was treated with antibiotics and recovered, the report said.

The second patient, who tested positive for a different strain of Legionella, suffered several complications after his transplant surgery, and died six months later from respiratory failure, it added.

A Survivor's Story: COVID-19 Ravaged His Lungs, Then A Transplant Saved His Life

VIRGINIA BEACH, Va. — Right now, there are more than 100,000 men, women, and children on the national transplant waiting list, according to data from the Health Resources Service Administration. Of those, 2,500 are Virginians.

Most people waiting are in need of a kidney. The heart transplant wait list is long too.

An organ donation surgery that is not as common is a double lung transplant. Life Net Health, based in Virginia Beach, says they see an average of 80 a year. Last April, a Virginia Beach man was one of them.

The journey Jim Stewart has been on is nothing short of miraculous. His harrowing story begins in early September of 2021 when he and his family came down with COVID-19. It hit Jim the hardest, and he wound up being admitted.

"Within a couple of weeks of being in the hospital, my condition worsened. I developed COVID pneumonia, and so I ended up on a ventilator and on October 1, I got airlifted to the UVA Hospital," Jim explained.

He was in a medically induced coma for six weeks and on a ventilator for a total of seven months.

Surviving after that much time on a vent is unprecedented. Staggering statistics were not in his favor, but he beat the odds.

"During the COVID era, a lot of people went on ventilators and the survival rate was 25%, and that's up to 90 days on a ventilator. After 90 days, it goes down to 5%," he said.

After some progress, Jim's condition took a turn towards dire. His lungs were failing.

It was then that his name went on the transplant list and surprisingly, a match was found in three days. He knows how unusual that short time frame is, noting that, "It was amazing how everything just lined up, and if it wasn't for the donor and the doctor's skill, I would not be sitting here talking with you today."

Not only was Jim's life saved as a result of this donor, but his doctor was also able to share that eight other people benefited because of the selfless decision to donate organs and tissue.

More and more people are signing up to become donors, according to Life Net Health. Since 2016, there's been an 89% increase in the number of organ donors.

"The community knows about the need. They're realizing this is not experimental and they're realizing they don't need to take their organs to heaven with them. They're really needed right here," said Life Net Health Executive Vice President Douglas Wilson.

Becoming an organ donor is extremely simple. You can register when you get or renew your driver's license at any Virginia DMV. Visiting this link is also a great option for registration.

According to Donate Life Virginia, last year, 29,000 lives were saved through organ transplants in the Commonwealth, and more than one million tissue transplants were performed.

Registering the decision to donate acknowledges your wishes to give someone the gift of life. Jim's gratitude led him to write a letter to his donor family. He shared a piece of it with us:

Dear Donor Family,

Your family's selflessness has given me a gift beyond measure. A gift that has not only saved my life but has granted me the opportunity to live anew. I carry your son's legacy with me every day and I'm determined to live a life that honors his memory and the selfless choice your family made.

The identities of the donor family and the transplant recipient are initially kept anonymous and confidential, with the transplant center coordinating any correspondence.

Jim felt he had to reach out, stating, "I just can't imagine what those parents went through. That's why I thought it was so important to share this with them. To give them, hopefully, a sense of hope that their son's life had an amazing purpose. That's my hope for myself - to live on purpose and be a positive impact on the world and the people in it. Thankfully, I have a second chance to do that."

A second chance is what organ and tissue donation is all about.

Hundreds of Virginians receive transplants each year, but two die every week waiting for the gift that does not come. Talk to your family about organ donation and should you decide to register, visit this link.

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