Man Battles Deadly Parasites 'Crawling In His Body' After Kidney Transplant—A Rare Risk Doctors Warn About

A horror that bothers most transplant patients came true in the most weirdest way possible, two U.S. kidney transplant recipients were found to be infected with parasitic worms from a single deceased donor. The shocking revelation was documented in a case report published June 18 in the New England Journal of Medicine, shedding light on rare but severe donor-derived infections that may be slipping through existing screening protocols.The source of the infections was traced back to a single deceased donor who had lived in the Caribbean, a region where some parasitic infections are more common. The donor’s kidneys were transplanted into two men at separate hospitals—Massachusetts General Hospital (MassGen) and Albany Medical Center—setting off a medical mystery that would take weeks to unravel.The first recipient, a 61-year-old man, underwent surgery at MassGen. Ten weeks after the transplant, he was readmitted to the hospital with a cascade of alarming symptoms: nausea, vomiting, excessive thirst, abdominal and back pain, and fever. His condition deteriorated rapidly, with fluid building up in his lungs, a dramatic drop in oxygen levels, and eventually, respiratory failure and shock. Doctors in the intensive care unit noted a distinctive purple rash—like a constellation of bruises—spreading across his abdomen.Dr. Camille Kotton, an expert in infectious diseases and transplants, led the investigation. She recalled previous cases of organ recipients being infected by Strongyloides stercoralis, a small roundworm commonly found in tropical and subtropical climates. Reaching out to New England Donor Services, the team discovered that the kidney donor—who had resided in the Caribbean—had indeed carried antibodies for Strongyloides, confirming prior exposure.Testing of the recipient’s blood confirmed he had no preexisting antibodies for the parasite before the transplant but had developed them afterward. Further diagnostics revealed the worms had spread systemically, affecting his lungs, abdomen, and skin. The parasite had essentially colonized his entire body, exploiting his weakened immune defenses.Further testing showed the patient had developed antibodies to the parasite post-transplant, and samples from his body revealed that the worms had spread to his abdomen, lungs, and skin.How Rare Are Parasitic Infections in Transplants?Infections from transplanted organs are exceedingly rare. Over more than a decade, only 14 out of every 10,000 organ transplants in the U.S. have resulted in donor-derived infections, according to a major review. Of these, parasitic infections—especially those caused by Strongyloides—account for a significant portion, but the overall numbers remain very low.Historically, fewer than one in four U.S. organ procurement organizations regularly screened for Strongyloides. However, as awareness of these risks has grown, the Organ Procurement and Transplantation Network in 2023 called for universal testing for this parasite in all donors.The discovery at MassGen prompted a nationwide alert to other centers that had received organs from the same donor. At Albany Medical Center, a 66-year-old man who had received the other kidney was experiencing fatigue, low white blood cell counts, and worsening kidney function. Armed with the new information, his doctors quickly diagnosed and treated the parasitic infection, preventing the severe complications seen in the first patient.Why it is Important to Strengthen Safety Protocols?This unsettling incident underscores the importance of rigorous donor screening, especially when donors have lived in regions where parasitic infections are more prevalent. The case has already prompted policy shifts and reinforced the need for continual vigilance in transplant medicine."Although donor-derived infections are uncommon, when they do occur, they can be catastrophic. We must use every tool available to prevent such outcomes," said Dr. Kotton.These cases have prompted renewed calls for rigorous screening of organ donors, especially those from regions where certain parasites are endemic. While U.S. doctors already avoid using organs from donors with known active infections like tuberculosis, not all infectious agents are routinely tested for, and some, like Strongyloides, can remain dormant and undetectable for years.Universal screening for Strongyloides is now being implemented, but experts caution that vigilance must remain high. Immunosuppressed patients—such as organ transplant recipients—are particularly vulnerable to rare infections, and symptoms can be easily mistaken for other complications like transplant rejection or drug reactions.For patients awaiting transplants, the story may raise unsettling questions, but experts stress that the benefits of organ transplantation far outweigh the risks. The U.S. transplant system has an excellent safety record, and cases like these, while alarming, are extremely rare and now more preventable than ever.Patients can play a role by staying informed, asking about donor screening protocols, and adhering closely to post-transplant care guidelines. As science and medicine evolve, so too does the capability to ensure safer, more effective transplants across the board.

Man Battles Deadly Parasites 'Crawling In His Body' After Kidney Transplant—A Rare Risk Doctors Warn About

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