Organ Donor Unknowingly Gave Rabies to Cornea Graft Recipients as Well as Kidney Recipient Who Died

In a troubling incident that has raised concerns about organ donation safety, three individuals who received cornea grafts from a deceased Idaho man have potentially been exposed to rabies. The donor, 59-year-old James Martin, is believed to have contracted the disease after being scratched by a skunk, which may have come into contact with an infected bat. While he initially appeared to have died from heart-related issues, subsequent medical investigations suggested rabies was the underlying cause.

James Martin’s family supported his decision to donate his organs after his passing in December 2024. During the donor assessment process, his health history was reviewed thoroughly. His wife, Kim Martin, disclosed the skunk encounter during the Donor Risk Assessment Interview (DRAI) questionnaire. However, testing for rabies is rarely conducted due to the infrequent occurrence of the disease being transmitted through organ donation.

Medical protocols typically focus on screening for more common infections like HIV and hepatitis. According to records, only three cases of rabies transmission via organ donation have been documented from 1978 to 2024. This rarity may have contributed to the oversight in testing Martin’s organs for rabies.

Following the transplant, Barney Kurowicki, a 76-year-old grandfather from Michigan, received Martin’s kidney. By January, Kurowicki began experiencing severe health challenges including weakness, tremors, and hydrophobia—symptoms that prompted medical professionals to suspect a rabies infection. As a precaution, the Centres for Disease Control and Prevention (CDC) were alerted to investigate the potential transmission of rabies through the organ donation process.

A serious conversation ensued between Idaho’s state epidemiologist, Dr. Christine Hahn, and the medical team overseeing Kurowicki’s care. With the possibility of rabies transmission raised, the decision was made to inform all recipients of the potentially infected tissue swiftly. This led to the removal of the grafted organs and the administration of post-exposure prophylaxis vaccines.

While the corneal graft recipients have not been publicly named, health officials confirmed that only one of the samples tested positive for rabies. Fortunately, none of the recipients exhibited symptoms of the disease, even several weeks after their transplants. This incident has underscored the urgency of improving protocols surrounding donor screening for rabies exposure to prevent such occurrences in the future.

In light of this situation, the Health Resources and Services Administration has suggested revising screening questions for organ donors to ascertain any potential risk of rabies exposure. Furthermore, they aim to establish a more structured process in collaboration with the CDC to evaluate the risk associated with organ donations.

Despite this alarming case, experts continue to stress that organ transplantation remains a highly safe procedure overall. David McCormick, a medical officer with the CDC, noted that the central challenge in the field is not the safety of the transplant process itself, but rather the critical shortage of available organs. He highlighted that 13 people die each day in the United States while waiting for organ transplants, emphasising the need for more public awareness and support for organ donation.

This unfortunate incident serves as a reminder of the complexities involved in organ transplantation and the importance of comprehensive donor screening to safeguard recipient health. Plans for enhanced protocols could help mitigate the risk of similar occurrences in the future, ensuring that organ donation continues to be a lifeline for many in need.