Recipients Get HIV and Hepatitis C With New Organs

[livecam]

4 Organ Recipients Infected With HIV

First Time HIV Has Been Spread In Organ Transplants Since 1985

CHICAGO (CBS) ― For the first time in more than 20 years in the U.S., the AIDS-causing HIV virus has been transmitted from a high-risk organ donor to transplant recipients, affecting four people in the Chicago area.

The transplants occurred in January at three Chicago hospitals, but the four patients who were infected with HIV and the virus for hepatitis C did not learn of their status until the last two weeks, according to medical officials.

A screening questionnaire determined the organ donor had engaged in high-risk behavior, according to officials at Gift of Hope Organ & Tissue Donation, the Elmhurst-based organ procurement agency that tested and approved the organs for donation.

But tests for HIV, hepatitis and other conditions came back negative, most likely because the donor had acquired the infections in the last three weeks before death. Personal details about the donor were not released by medical officials, who cited privacy laws.

Based on the negative test results, doctors at Northwestern Memorial Hospital, Rush University Medical Center and the University of Chicago Medical Center went ahead with the transplants.

"It's a risk-versus-benefit calculation," Alison Smith, vice president for operations at Gift of Hope, told the Chicago Tribune. "Every patient in need of an organ has a significant medical condition that in most circumstances limits life expectancy. The question becomes what degree of risk is appropriate in that situation."

The right procedures were followed in testing the donor, according to Smith, who attributed the failure of the standard ELISA test to detect HIV and hepatitis C to the inability of the test facilities use to detect the virus in newly infected people.

A newer test called NAAT appears to reduce the window of time in which infected patients may go undetected, and Illinois should consider using it, said Dr. Michael Millis, chief of the transplantation program at the University of Chicago Hospitals.

"The organ supply is extraordinarily safe, but this has demonstrated that it's not 100 percent safe and it is never going to be 100 percent safe, at least with technology we have today," Millis said. "The process needs to be done as well as it can be, and I think we can improve it."

Millis said his staff was told of the problem on Nov. 1, and brought in the two patients who had transplants there for testing the next morning.

"It was very surprising and devastating for them, I'll be honest, just as it would be for any of us," Millis said.

A spokesman for the United Network for Organ Sharing said the last known example of HIV being transmitted from a donor to a recipient was in 1985, when the AIDS virus was still relatively new and few safeguards were in place to prevent transmission. Since then, there have been more than 400,000 organ transplants in the U.S. without a reported case of transmission through organs.

The Centers for Disease Control and Prevention 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."

[Romona]

Quite an eye opener. 

[Joe Paul]

You just never know 

[Sluff]

Adding to the fear factor..geeez.

[livecam]

Adding to the fear factor..geeez.

I hesitated about posting this but going into this with eyes wide open helps.

[paris]

This is so much like Amanda's situation.  My daughter works for the Aids Allliance and she and I have had several debates about HIV and organ donation.  Guess who I am sending this artilce to!  Maybe some fireworks at our house tonight!!     I feel so bad for those 4 who received those organs.  This is all hard enough without one more worry.

[MyssAnne]

I read that this morning. All the more reason to hunt for your own donation, I guess.

[goofynina]

Thats some scary stuff man 

[Hippy]

This sounds like BS or worse ? Its safe but not safe ?
It can be improved but they don't do the latest testing, why not. I think the responsible people should lose their jobs. Otherwise changes will be slow.

"A newer test called NAAT appears to reduce the window of time in which infected patients may go undetected, and Illinois should consider using it, said Dr. Michael Millis, chief of the transplantation program at the University of Chicago Hospitals. "

"The organ supply is extraordinarily safe, but this has demonstrated that it's not 100 percent safe and it is never going to be 100 percent safe, at least with technology we have today," Millis said. "The process needs to be done as well as it can be, and I think we can improve it."

[Amanda From OZ]

What a beautiful health systerm we have....

[kitkatz]

Well F***!

[Chris]

How about updating a test procedure that is 20 years old with modern biotechnology is on thought. The news here in Chicago stated that the organs were from a questionable donor (drug user) and that the recipients should have been notified of that. Northwestern did not offer me that type of information about my donor at the time of my transplant and if that was the case, I would have made the decision not to have had a transplant based off that information. So if a recipeint is suppose to be notified about the donors condition, Northwestern and a couple patients I met from University of Chicago were not offered this info to make a informed decision. Luckily we didn't have this problem. Goes to how that there needs to be some improvements in the system. When I was in the hospital at Northwestern when the news broke and the nurse comes in at the same time, the look on her face as I looked at her (she was going to take vital), she had the look on her face that she wanted to hide. We sometimes take things for granite and it goes to show that we can not be laxed on testing techniques. Just because it has worked this good for twenty years is no excuse not to improve upon it.

Now the question goes, if these patients need to be re-transplanted, will they be given the same fair chance of receiving a healthy organ as someone without HIV? There already has been an issue over that with HIV patients needing an organ transplant.

This is one blunder that needs to be corrected with an equal chance of a healthy outcome for these patients.

[paddbear0000]

This is horrible! I already have fears of getting a transplant. This does not help at all!

[boxman55]

Good Grief what a nightmare...Boxman

[George Jung]

Given the fact that is has been over 20 years since this has happened I don't see any need for alarm.  Who has ever guaranteed anything?

All the more reason to hunt for your own donation, I guess.

There is a greater chance of something happening on the operating table to a perfectly healthy person than there is of this happening to you or I.  Not knowing the history of a donor organ is something to consider but to me it is not one of the bigger factors.

The question that comes to my mind is that since we thank god when things go in our favor (getting a transplant), just as I am sure these families did, who do we need to talk to and show our disapproval when they go the other way.  There is no doubt in my mind that these 4 families were thanking god for these transplants until the moment they learned what they have to face now.  The communication to god now must be "why".  Maybe this is god's plan for these people.

"A newer test called NAAT appears to reduce the window of time in which infected patients may go undetected, and Illinois should consider using it, said Dr. Michael Millis, chief of the transplantation program at the University of Chicago Hospitals. "

"The organ supply is extraordinarily safe, but this has demonstrated that it's not 100 percent safe and it is never going to be 100 percent safe, at least with technology we have today," Millis said. "The process needs to be done as well as it can be, and I think we can improve it."

1st - "appears" doesn't sound like a guarantee either, it sounds like someone "thinks" so.
2nd - who ever said the organ supply was 100% safe?
3rd - that is obvious now, but sometimes something has to go wrong before we know if it can be improved or how to improve it.

[oswald]

never thought of it that way.  it's still upsetting to hear that these people got these horrible diseases on top of esrd.   

[paddbear0000]

Given the fact that is has been over 20 years since this has happened I don't see any need for alarm.  Who has ever guaranteed anything?

The number of AIDS/HIV cases has also exploded during those 20 years.

[George Jung]

Also, it sounds like the organs came from ONE donor.  If we were to hear about a rash of these articles at hospitals from all over the states, not just Chicago, then it would be rational to be concerned

A screening questionnaire determined the organ donor had engaged in high-risk behavior, according to officials at Gift of Hope Organ & Tissue Donation, the Elmhurst-based organ procurement agency that tested and approved the organs for donation.

[okarol]

More info here:

HIV From Organ Donor Infects Chicago Transplant Patients

Article Date: 14 Nov 2007 - 3:00 PST
Written by: Catharine Paddock
MEDICAL NEWS TODAY

Four Chicago transplant patients have developed HIV and hepatitis C believed to have come from a single donor whose original HIV test may have been a false negative because the infection was too recent to register on screening tests, said health officials yesterday, Tuesday 13th November.

Dr Matthew Kuehnert, director of blood, organ and tissue safety at the US Centers for Disease Control and Prevention (CDC) told the press this was the first time in 20 years that organ donation had infected patients with HIV.

Recent tests have confirmed that the organ donor, and all four patients who underwent transplant operations in three different Chicago hospitals, have tested positive for HIV and hepatitis C, said Kuehnert, who emphasized it was very unlikely that this would have happened "by chance".

Investigations have shown that nobody else has received contaminated organs or tissue from the infected donor, said Kuehnert.

The CDC will be carrying out its own tests to see if the four patients have been infected with the same strain of HIV and if it matches the strain from the donor.

Health officials are also investigating whether the four patients may have unknowingly passed on the virus during the months since their operations, which took place in January.

Unfortunately the hospitals did not test the patients shortly after their transplant operations, which would have reduced the risk to others, Kuehnert said to the Chicago Tribune.

It would appear, said Kuehnert, that of the three hospitals, Rush University Medical Center, Northwestern Memorial Hospital and the University of Chicago Medical Center, had not followed CDC guidelines for testing patients for HIV shortly after a transplant operation.

According to Kuehnert the organs were donated by a high risk donor, which would suggest they fit more than one criteria of HIV infection risk, for instance being an intravenous drug user, serving a prison sentence, or being a man who has had sex with men in the previous five years.

Mandy Claggett, a spokeswoman for United Network for Organ Sharing or UNOS who set organ donation policy, told Reuters news agency that all the policies were followed and the tests were carried out correctly on the organ donor, but unfortunately they came back as a false negative result.

There are two types of test for HIV, one is quite fast and the other takes much longer. The fast one screens for antibodies, this is the ELISA antibody screening test. Apparently this was the test that gave a false negative on the donor, and it turns out that a repeat test after the infections were discovered, also came out negative. This could happen if the donor had been infected only recently before they died.

The slower test, called the nucleic acid amplification test, or NAT, looks for the genetic material of the HIV or hepatitis C pathogen, and can therefore detect the presence of a virus shortly after infection, before the body has had time to produce enough antibodies to show up in the antibody test.

The problem lies in the balance of risk against speed. The more accurate test takes longer, but that introduces a delay in a process that could be a matter of life and death for the recipient. Also, as Kuehnert told the press, the reason that high risk donors are even considered for organ donation is because there is a shortage of donors.

He said patients on the transplant list who are concerned about the risks should talk to their doctor.

http://www.medicalnewstoday.com/articles/88666.php

Click here for Reuters report "Four Chicago transplant recipients contract HIV". http://www.reuters.com/article/middleeastCrisis/idUSN13630047

Click here for Chicago Tribune report "Organ patients' spread of HIV probed". http://www.chicagotribune.com/news/local/chi-organ14nov14,0,6873232.story?coll=chi-newsbreaking-hed

[lola]

When Otto had his transplant in 1993 he had HIV test every month for 1 year and we were told to use condoms for the 1st year after transplant, don't they still do that? This is so sad

[Chris]

Well since I had my transplant at Northwestern, they have never tested me for HIV and only tested me for Hep C prior to transplant, not after.

[Amanda From OZ]

The problem is that NATT testing is never done, only in VERY RARE occasions, and if they are done.. they are not done until it is too late.  so whats the point.

Also, it sounds like the organs came from ONE donor. If we were to hear about a rash of these articles at hospitals from all over the states, not just Chicago, then it would be rational to be concerned

A screening questionnaire determined the organ donor had engaged in high-risk behavior, according to officials at Gift of Hope Organ & Tissue Donation, the Elmhurst-based organ procurement agency that tested and approved the organs for donation.

There has been MANY known cases of people testing positive for HIV, and hepatitis c many years after a transplant, but there was no way to prove how they contracted it.

I have spoken to many people at the health department, and this has more than likely happend before and will continue to happen unless two things change, first of all NATT testing should be done on all donors who are high risk, and if there is not enough time frame to do it, then the organs should not be used. Also because of the lack of donors in the world, peoples lives are being compromised and they are accepting any organs they can get. 

This makes me sick...

[livecam]

When Otto had his transplant in 1993 he had HIV test every month for 1 year and we were told to use condoms for the 1st year after transplant, don't they still do that? This is so sad

I was tested once as part of the workup but never again to my knowledge.  There were no warnings given about personal cautions or behaviors to be followed after the transplant.

[lola]

I wonder if it was because he was 22 and we weren't married? But he was tested 1x before and 2X's after