Investigation into Possible Link Between Lung Transplant and Legionnaires’ Disease

The Centers for Disease Control and Prevention determined in a Friday report that a pair of transplanted lungs from a drowned donor in Pennsylvania likely caused Legionnaires’ disease in two recipients.

The two recipients are the first people whose Legionnaires’ disease infections were found to likely come from transplanted organs, the CDC said.

Laboratory testing did not conclusively determine the source of the Legionnaires’ infections.

Researchers determined the organs were the cause because of the donor’s exposure to the river water and because no other Legionnaires’ disease infections were reported at the hospital where the transplants were performed in the six months before and six months after the procedures.

The bacteria that causes the disease, Legionella, thrives in warm water, and there have been previous cases of people getting the disease after inhaling warm freshwater while nearly drowning.

In this case, the deceased donor, a man in his 30s, had drowned after having been submerged for over five minutes in a river.

While the man’s organs were removed and transplanted to other patients within seven days of his death, doctors did not suspect a Legionella infection and did not test the organs for the bacteria, the CDC said.

The Pennsylvania Department of Health began looking into the pair of infections after they were first reported in July 2022. The organ transplants took place in May 2022.

The first recipient, a woman in her 70s identified by the CDC as patient A, received doxycycline antibiotic treatment after her Legionnaires’ infection was discovered, and recovered.

The second recipient, a man in his 60s identified by the CDC as patient B, did not survive, ultimately dying in November 2022 after a mucous plug in his lungs caused respiratory failure, the CDC said.

The recipients of the drowned donor’s other organs, mainly the man’s heart, kidney and liver, did not suffer complications that suggested a Legionnaires’ disease infection, the CDC said.

Researchers said the episode highlights the need for added precaution before transplanting organs from freshwater drowning victims.

“This cluster highlights the need for increased clinical awareness of possible infection with Legionella in recipients of lungs from donors who drowned in freshwater before organ recovery,” CDC researchers wrote.