Michigan resident succumbs to rabies post-transplanted kidney carrying the deadly virus, marking an unusual occurrence
Rare Case of Rabies Transmission Through Organ Transplantation in the U.S.
A recent incident in the United States has highlighted the extremely rare but potential risk of rabies transmission through organ transplantation. In January 2025, a Michigan resident died of rabies after receiving a kidney transplant in Ohio, marking the first human case of rabies in the state since 2009 [1].
The recipient of the donor's kidney and three other patients who received corneal grafts from the donor's eyes in three different states have all received rabies post-exposure prophylaxis shots and are currently in good health [1]. The Michigan resident's rabies was confirmed by the CDC Rabies Laboratory.
Rabies is a deadly disease caused by a virus that affects the central nervous system of mammals, including humans. It is typically transmitted through the saliva of an infected animal via bites and open wounds, such as scratches. The incubation period for rabies can vary from a few days to several years [3].
In the U.S., 7 out of 10 people who die from rabies are infected by bats [5]. The organ donor in this case was exposed to rabies from a wild animal in Idaho five weeks before they died [6].
While the risk of not getting a transplant if one has organ failure is higher than the rare risk of rabies transmission, stringent donor screening and surveillance efforts are in place to mitigate the risk. The Organ Procurement and Transplantation Network (OPTN) has policies that exclude donors with confirmed rabies infection or risk [4]. However, due to the incubation period of rabies and difficulty in early diagnosis, occasional transmission events still occur.
The CDC has warned of a rise in rabies deaths in the U.S., with about 800,000 people receiving rabies-related medical care from local or state health departments around the country every year [7]. It is important to note that rabies can be prevented with post-exposure prophylaxis (PEP), which includes immediately washing the wound with soap and water for at least 15 minutes, and receiving four or five doses of the rabies vaccine over the course of 14 days after the bite [8].
In a statement, Dr. Daniel Kaul, a clinical professor at the University of Michigan's Infectious Disease Clinic, emphasized the importance of transplantation in saving lives, saying, "The risk of not getting a transplant if one has organ failure is higher than the rare risk of rabies transmission" [9].
This incident serves as a reminder of the importance of adhering to rabies prevention protocols, particularly for those who work with animals or are exposed to wild animals. It also underscores the need for continued vigilance and stringent screening practices in the organ transplantation process.
- Despite the risk of not getting a transplant being higher than the rare risk of rabies transmission, stringent donor screening and surveillance efforts are in place in the health-and-wellness sector to mitigate risks in organ transplantation, such as the exclusion of donors with confirmed rabies infection or risk, as overseen by the Organ Procurement and Transplantation Network (OPTN).
- In addition to adhering to stringent screening practices in organ transplantation, it is crucial to follow rabies prevention protocols, especially for those working with or exposed to medical-conditions like rabies in animals, as this incident illustrates the potential risk of transmission, even though the United States typically sees only a few cases of rabies transmission, such as the one caused by a wild animal exposure, as observed in the recent Michigan case.
