Empire State Review Team 
Rare Case of Rabies Transmission Through Organ Donation in Michigan
In a distressing incident, a Michigan resident has succumbed to rabies after receiving a kidney transplant from an organ donor at the University of Toledo Medical Center in Ohio. Health officials report that this case is exceedingly unusual and marks Michigan’s first rabies-related death since 2009.
Details of the Incident
The patient underwent a kidney transplant in December 2024 and tragically passed away in January. Following an investigation involving the Michigan Department of Health and Human Services, the Centers for Disease Control and Prevention (CDC), and the Ohio Department of Health, officials traced the source of the rabies infection back to the transplanted organ.
Donor’s Background and Infection Source
The organ donor had reportedly come into contact with a rabid animal in Idaho approximately five weeks prior to their death. Alarmingly, the donor did not present any typical symptoms associated with rabies, such as confusion or seizures, nor did they report their potential exposure to health authorities.
Transmission Through Organ Transplant
Rabies is known for its near-certain fatality rate once clinical symptoms emerge, making this case particularly somber. The organ recipient began to show symptoms shortly after the transplant and succumbed to the disease within weeks. Documented cases of rabies transmission through organ donation are rare, but they do exist. A noted example is a 2005 case that resulted in the death of four transplant recipients from rabies-infected organs.
Status of Other Recipients
The transplant included not only the kidney but also corneal tissue given to three recipients across various states. Fortunately, all of these patients received post-exposure prophylaxis (PEP) and are reported to be stable. Additionally, a corneal graft designated for Missouri was intercepted before implantation could occur.
Investigations and Future Implications
Health officials in Michigan have conducted assessments of healthcare workers and others who may have interacted with the transplant patient and provided rabies PEP when necessary. However, key questions remain unanswered, such as why the donor’s potential rabies exposure was not disclosed and whether symptoms were evident during the screening process.
Challenges in Rabies Testing for Donors
Dr. Daniel Kaul, an infectious disease expert at the University of Michigan, noted that while cases like this are tragic, they are extremely rare. He emphasized that the risks of not receiving a transplant in cases of organ failure far outweigh the dangers associated with rabies transmission. Testing for rabies in organ donors presents complications, as the testing process can take longer than the critical time required for organ viability. While symptoms and past exposure are grounds for exclusion, they were not apparent in this specific case.
Conclusion and Health Recommendations
This incident underscores the critical, albeit rare, risk posed by undiagnosed infections in organ transplant scenarios. Health authorities continue advocating that organ transplants are primarily safe. Approximately 800,000 individuals in the U.S. receive rabies-related medical attention yearly, yet fewer than 10 fatalities are recorded annually due to the disease according to the CDC.
Medical experts suggest that heightened awareness regarding animal exposures and efficient reporting to public health officials may help mitigate risks of future donor-related rabies cases. The CDC, in collaboration with state agencies, continues to examine protocols to prevent such occurrences going forward.
Further Information
The information presented here is based on reports from the Associated Press, the Michigan Department of Health and Human Services, and insights from the CDC. Additional data were referenced from studies in the New England Journal of Medicine and the journal Transplantation, which document similar rabies transmission cases through organ donation.
