Two organ recipients contracted Legionnaires' disease after receiving organs from a single donor who died drowning in a fresh body of water, according to a Sept. 15 CDC report. The incident raises concerns and new considerations for clinicians to take into account.
Shortly after receiving lung transplants from the same donor, in July 2022, the Pennsylvania Department of Health confirmed reports of Legionnaires' disease in the two organ recipients.
Since Legionella bacteria naturally live in freshwater, initially water at the hospital where the transplants took place was also evaluated as a possible source of infection, but was ultimately determined not to be.
"Although laboratory testing did not confirm the source of recipient infections, available data suggest that the most likely source was the donor lungs," the CDC report reads. "This cluster highlights the need for increased clinical awareness of possible infection with Legionella in recipients of lungs from donors who drowned in fresh water before organ recovery."
The agency recommends that clinicians who care for patients who have received an organ donation from someone who has drowned in freshwater "maintain a higher index of suspicion for legionellosis, even in organ recipients without classic clinical symptoms. In such patients, posttransplant antimicrobials could be tailored to include agents that combat atypical waterborne organisms."