• Man in Michigan dies after kidney transplant from infected donor
• Infection transmitted through a chain described by doctors as rare

A man in the U.S. state of Michigan died from rabies after receiving a kidney from a donor who had died from the same disease, an event officials described as extremely rare.

The donor, from Idaho, had been scratched by a bat while rescuing a cat under attack.

According to a recent report by the U.S. Centers for Disease Control and Prevention (CDC), the Michigan patient underwent a kidney transplant at an Ohio hospital in December 2024.

About five weeks later, he began experiencing tremors, weakness in the lower limbs, confusion, and urinary difficulties, and was subsequently hospitalized and placed on a ventilator before he passed away.

Post-mortem tests confirmed rabies infection, which puzzled authorities, as the patient’s family stated he had no contact with animals.

Review of the donor’s records revealed he had noted a bat scratch in his risk assessment form. The family reported that the donor had been carrying a small cat in a rural home storage area when a bat approached aggressively in October 2024.

The man intervened to protect the cat, resulting in a scratch to his leg, which he did not realize involved a bite.

Approximately five weeks later, unusual symptoms appeared, including confusion, difficulty swallowing and walking, hallucinations, and neck stiffness.

Two days later, he was found unconscious at home due to cardiac arrest. Despite resuscitation and hospitalization, he never regained consciousness and was declared brain dead after several days, with life support withdrawn.

Several of his organs, including the left kidney, were donated.

After suspicion of rabies in the kidney recipient, authorities re-tested the donor’s lab samples, which were negative. However, samples taken directly from the kidney revealed a rabies strain matching that of a silver-haired bat, indicating the donor had indeed died from rabies and transmitted the infection to the recipient.

Investigations suggested a three-step transmission chain: the bat infected the donor, who then transmitted it via the kidney to the recipient.

The CDC noted this is the fourth documented case of rabies transmission via organ transplant in the U.S. since 1978, emphasizing that the risk of infection through transplantation remains extremely low.

After discovering that three other people had received corneal transplants from the same donor, authorities immediately removed the tissues and administered post-exposure prophylaxis (PEP) to prevent infection; these individuals remained symptom-free.

The report explained that families generally provide information on potential infectious risks, including animal exposures, and that rabies is typically excluded from routine donor screenings due to its rarity and diagnostic difficulty.

It also noted that the medical team treating the donor was unaware of the bat scratch at hospital admission, attributing initial symptoms to chronic health issues.