LAUSR

HTLV-1 infection is a neglected disease that affects 10-15 million people worldwide. Up to 10% of carriers will develop clinical manifestations lifelong, including leukemia/lymphomas and subacute myelopathies. HTLV-1 transmission following solid organ transplantation has been associated with more frequent and rapid disease development of myelopathy. We report two recent cases of HTLV-1 transmission following kidney transplantation from a single HTLV-1 donor. He was a native Spaniard who had a sexual partner from an HTLV-1 highly endemic region. One recipient developed myelopathy within the first year whereas the other patient seroconverted but remains asymptomatic following discontinuation of immunosuppressants after removal of the organ due to rejection. In addition to these two cases, another previous three recipients of solid organ transplantation became infected with HTLV-1 from a single donor, who was also a native Spaniard whose mother was from an HTLV-1 highly endemic country. Altogether, our findings support that American and European societies/agencies should update their policy recommendations on organ transplant HTLV-1 screening. In the meantime, diagnostic companies should be urged to improve the specificity of HTLV-1 tests and design rapid tools (i.e., point-of-care assays) to minimize the risk of transplanting HTLV-1-infected organs. This article is protected by copyright. All rights reserved.