A Life-Saving Transplant Turned Tragic
A Michigan resident lost his life to rabies after receiving a transplanted organ, according to health officials. This tragic case has raised concerns about the risks associated with organ transplantation and the rare but dangerous possibility of transmitting diseases through donor organs.
The Centers for Disease Control and Prevention (CDC) disclosed the incident in a recent report, detailing that the man received a left kidney from a donor in Idaho in December 2024. Approximately five weeks later, he began experiencing symptoms such as tremors, limb weakness, confusion, and urinary incontinence. A week after these initial signs, he developed a fever, had difficulty swallowing, was unstable on his feet, and exhibited a fear of water—symptoms commonly associated with rabies.
He was admitted to the hospital, and the CDC was notified. Unfortunately, seven days after his hospitalization, the organ recipient passed away. Postmortem testing confirmed that he had contracted rabies.
Further analysis revealed that the rabies strain found in the man was consistent with the silver-haired bat variant. However, his family reported no direct exposure to animals. This led officials to suspect that the donor might have been the source of the infection. Prior to the donation, the Donor Risk Assessment Interview (DRAI) questionnaire indicated that the donor had been scratched by a skunk.
The donor’s family later shared that he had encountered a skunk on his rural property in Idaho. During an incident where the skunk became unconscious, the man was scratched by the animal and started bleeding. At the time, he told his family that he didn’t believe he had been bitten. However, five weeks after this encounter, the donor began showing symptoms such as confusion, difficulty swallowing, walking, hallucinations, and a stiff neck. Two days later, he was found unresponsive at home, resuscitated, and hospitalized, but never regained consciousness.
He was declared brain dead and removed from life support five days later. His left kidney, heart, lungs, and both corneas were recovered for transplantation.
After the donor was identified as a potential source of the infection, stored lab samples were tested and came back negative for rabies. However, biopsy samples from his kidneys revealed a rabies strain consistent with the silver-haired bat, indicating that the infection may have originated from the organ itself, according to the CDC report.
Four grafts from the donor’s corneas were planned for transplant. Three patients received them in December 2024 and January 2025. Upon investigation of the rabies case, those grafts were removed from the recipients, and the fourth transplant was canceled. The CDC later detected rabies in one of the previously implanted corneal grafts.
To prevent further infections, the patients received Post-Exposure Prophylaxis (PEP). No additional cases were reported.
The heart and lungs were never transplanted but were used for training purposes in Maryland. By the time of the investigation, no samples remained for rabies testing.
Understanding Rabies: A Lethal Threat
Rabies is a fatal viral disease that affects the central nervous system. It is typically transmitted through the saliva of infected animals such as dogs, raccoons, bats, coyotes, and foxes. The disease is nearly always fatal in humans if left untreated.
Early symptoms include fever, headache, agitation, confusion, and vomiting. As the infection progresses, patients may experience excessive salivation, hallucinations, difficulty swallowing, and partial paralysis. While a series of vaccines can be administered after a person suspects they’ve been exposed to rabies, there is no effective treatment once symptoms appear.
Although direct human-to-human transmission of rabies has never been confirmed, it can occur in extremely rare cases involving infected organ or tissue transplantation.
A 2018 study published by the National Institutes of Health (NIH) stated that “undiagnosed or misdiagnosed rabid donors are the reason for rabies virus transmission via solid organ or tissue allotransplantation.”
It remains unclear how the infection spreads from a tainted organ to the rest of the body. The most recent CDC report indicates that this is the fourth reported case of rabies transmission through organ transplantation in the U.S. since 1978, with the overall risk being low.
In total, 13 organ recipients have been involved in the four events. Seven who did not receive PEP died, while six who did receive PEP survived.
While organs are routinely screened for infectious diseases, cancers, quality, and functionality before transplantation, rabies testing is not typically performed due to its rarity and the time it takes to get results.
On average, around 4,000 animal rabies cases are reported each year, with over 90% occurring in wildlife and fewer than 10 human deaths annually, according to the CDC.