Posted on 11/13/2007 6:25:58 PM PST by paltz
CHICAGO (CBS) ? There are new questions about the safety -- and risks -- of organ donation. As CBS 2 Medical Editor Mary Ann Childers reports, this comes after four patients at three Chicago hospitals got HIV – which causes AIDS – after receiving infected donor organs.
This is the first known instance of HIV transmission from an infected donor in the U.S. in more than 20 years. It happened despite proper procedures for testing donors and organs that experts say were followed to the letter by the Elmhurst-based Gift of Hope Organ & Tissue Donor Network, which serves Illinois and northwest Indiana.
Gift of Hope says the organs tested negative for HIV and hepatitis C because it takes 22 days from the time a person is infected until their immune system forms antibodies blood tests can detect. The donor was tested to rule out the presence of any transmissible disease. Tests for HIV, hepatitis and other conditions came back negative, possibly because the donor had acquired the infections in the last three weeks before death, or because the tests might not have picked up the diseases.
"These tests are not infallible," said Alison Smith of Gift of Hope. "There's limitations on these tests."
A genetic test approved in 2002 can reveal these infections sooner, but it takes longer to analyze, and has a high false positive rate that might exclude healthy organs.
The United Network for Organ Sharing says the Centers for Disease Control also requires a medical history and lifestyle questionnaire. The CDC guidelines advise excluding high-risk patients from organ and tissue donation, "unless the risk to the recipient of not performing the transplant is deemed greater than the risk of HIV transmission and disease."
"Since 1994, the CDC has required screening for all high risk donors. This is the first case of HIV since 1994," said Joel Newman of United Network for Organ Sharing.
It was known the Illinois donor had engaged in high-risk behaviors. The CDC says those include sex between men and intravenous drug use. Nine percent of all donors fit that profile.
"The problem is with the shortage of available organs," Smith said. "We just don't have enough to go around."
More than 98,000 Americans are waiting right now for donor organs. Sixteen people on that waiting list die every day.
"As much as we try to reduce risk, we can't make it zero risk," Newman said. "For any blood test or surgical procedure we do what we can to make the risk the smallest possible."
Based on negative test results -- and the risks of doing nothing -- the transplants took place in January. One was at Rush University Medical Center, the second at the University of Chicago, and the third at Northwestern Memorial. But patients only learned they were infected a few weeks ago.
"We are extremely distraught over this and just want them to know that our thoughts and prayers are with them," Smith said.
Smith said across the country, about 9 percent of all donors fall into the "high-risk" group.
"There would be a lot of other people that had died waiting for an organ had those donors been ruled out," Smith said.
She said all parties involved must weigh the risk versus the benefit.
Rush University Medical released a statement regarding the infections.
"This is truly an unfortunate occurrence, and although extremely rare, Rush will be working with other transplant centers, the Gift of Hope, and the United Network for Organ Sharing to determine how this may be prevented in the future," Rush spokesman John Pontarelli said in the statement.
That likely will involve determining which donor tests are best, and what behavioral risks are acceptable.
Since 1985 when three people died of AIDS after receiving infected organs from a man in Virginia, there have been more than 400,000 transplants in the U.S., without a reported case of transmission.
When organs become available it's the responsibility of the medical team and the patient to analyze risk and make decisions. Accepting an organ from a higher-risk donor is just one of the risks inherent in organ transplantation.
CBS 2's Mary Ann Childers and Kristyn Hartman and the Associated Press contributed to this report.
Guess admitting to IV drug use and homosexual behavior are not enough to get your organs refused.
The “donor” had high risk lifestyle issues ( per Brit Hume tonight on the Fox News Report) and died three weeks after the testing was done, thus his/her organs were infected at that time.
That is why my old Family physician (My Dad) always gave blood to my family members prior to surgery and we have kept this ensible tradition alive.
Nine percent of donors are either men buggering men or heroin/meth addicts???? Holy Mother of God!
It was known the Illinois donor had engaged in high-risk behaviors. The CDC says those include sex between men and intravenous drug use. Nine percent of all donors fit that profile.
“The problem is with the shortage of available organs,” Smith said. “We just don’t have enough to go around.”
Now that’s brilliant - using high risk donors to meet demand.
We’ve tried to do that and always been told they can’t do it....how do you get it done?
Should have been a clue.
I agree, but there is a shortage, and most of the people who receive organs are in dire straits and most die b4 receiving an organ. They are supposed to get informed consent from the donors.
However, last year some homosexual activists were demanding that the CDC stop asking questions on the donor form, suggesting that people should lie, and deny any risky behaviours since testing was done anyway.
Welcome to paradox number 8,927,371 in the continuing series emanating from the way in which the HIV/AIDS epidemic has been handled as a matter of public heath policy.
The indication that 9% of organ donors fit the high risk profile (gay sex, IV drug use, etc.) was rather shocking. In addition to that being a risk I had assumed was effectively screened - it give one pause to consider why someone who engaged in that behavior would want to be an organ donor. In this particular case - it had to be someone who engaged in risky behavior in a relatively short time period before death. That's downright mean.
Since 1985 when three people died of AIDS after receiving infected organs from a man in Virginia, there have been more than 400,000 transplants in the U.S., without a 4 reported cases of transmission.
Not likely to be real comforting to the unlucky 4, and hardly six-sigma quality controls.
I would guess the high percentage of high risk donors include people who might have travelled to Africa or Asia at some point in their lives, or had ever done any drugs etc. In other words things done long ago not within the incubation period. If they knew this guy was a practicing homosexual and drug addict it changes things.
Doc : I have good news, and I have bad news,
Pt - Go ahead
Doc - We finally found a perfect match for a replacement heart for you.
Pt - My goodness, that is good news indeed. Eeerrr - what’s the bad news?
Doc - The donor is Freddy Mercury......
(ya, I know, Freddy *is* dead)
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.