Candida auris in Heart Transplant Donor: First Isolation in a Southern Italy Heart Transplant Center

Candida auris is an emerging multidrug-resistant fungal pathogen increasingly implicated in healthcare-associated outbreaks worldwide. Its presence in organ donors poses a significant threat to transplant recipients due to the risk of invasive infection and limited antifungal treatment options. We report the first isolation of Candida auris in a heart transplant donor at a transplant center in Southern Italy. The donor, a 45-year-old woman from Greece, was colonized with C. auris in the bronchoaspirate sample collected at the time of organ retrieval. Despite this colonization, the donor heart was successfully transplanted into a 62-year-old male recipient with end-stage heart failure secondary to myocardial infarction and cardiogenic shock. The recipient received targeted perioperative prophylaxis and was placed under strict isolation protocols. Repeated microbiological surveillance, including blood, urine, and mucosal cultures, revealed no evidence of C. auris transmission. Environmental surveillance of the operating room and ICU also tested negative. The patient recovered uneventfully, showing good cardiac function and no signs of graft rejection or infection. This case emphasizes the critical importance of early detection, thorough microbiological assessment, and stringent infection control in transplantation involving donors colonized with multidrug-resistant organisms. It also raises the question of whether C. auris should be routinely screened in potential donors and if specific transplant guidelines should be developed to address such emerging threats.