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A rare, unfortunate consequence of organ transplantation is the transmission of unrecognized infections or malignancies from donors to recipients. Recent reports have described the transmission of human herpesvirus 8, histoplasmosis, West Nile virus (see Journal Watch Infectious Diseases Jan 1 1999, Nov 2 2000, and Nov 8 2002), glioblastoma, and now rabies to solid organ recipients.
In May 2004, recipients of kidneys, a liver, and a vascular graft from a common donor developed rapidly progressive encephalitis within 30 days of surgery and died. Histopathologic evaluation, which included immunohistochemical and direct fluorescence antibody assays, showed evidence of rabies in all four recipients; neurologic disease consistent with rabies deve…