Four Organ Transplant Recipients get HIV and Hep C from Donor

By Anastacia Mott Austin

Four transplant patients who received organs from a single donor got devastating news recently, when it was discovered that all of them had been infected with HIV and Hepatitis C.

In the first such case in more than 20 years, the four received organs from the same donor in January of this year and were told in the last two weeks that they all carried the viruses.

One major concern is whether the recipients may have unwittingly passed the diseases on to their intimate contacts.

The donor was classified as "high risk" at the time of the organ donations, say health officials, yet initial HIV and Hep C tests were negative. This can occur when the infection is recent and the body has not had sufficient time to develop antibodies to the virus. The donor would have had to contract the diseases within a few weeks before his or her death (the donor’s gender was not revealed).

Part of the challenge in performing accurate virus testing is that the most commonly used test, the ELISA (Enzyme-Linked ImmunoSorbent Assay) is used because the results can be obtained quickly – an absolute necessity when dealing with vital organs which lose viability with each minute that passes. The ELISA tests for antibodies to viruses, not the diseases themselves.

A more detailed, accurate test can be done, (the NAAT, or Nucleic Acid Amplification Testing, which detects the genetic material of viruses) but the results take too long, and many healthy organs can potentially be lost.

Transplant recipients are warned that there is a slight chance their donated organs may harbor illnesses not detected by initial testing. Transplant experts say that the slight risk of contracting diseases is still far outweighed by the benefit of receiving an organ that may otherwise not be available for years.

"In the big picture the risk of obtaining a disease is a very small part of the picture for someone who needs an organ," said Dr. James Burdick, from the transplantation division at the Health Resources and Services Administration. "The chances of acquiring HIV from a donor are vanishingly small, and this one case doesn't prove differently."

Health experts say that the transplant recipients should have been tested within three months after their surgeries, and despite the fact that they were patients at three different Chicago-area hospitals, none of them were tested.

This points out a gap in the system, says Dr. Matthew Kuehnert, the CDC’s director of blood, organ, and tissue safety. "It’s something that we’re concerned about and we’re asking questions about through the Health Department," said Dr. Kuehnert to reporters.

Joel Newman, a representative of the Network for Organ Sharing, told the press that of the 400,000 cases of organ transplants since 1986 in the United States, none have been responsible for transmission of HIV until now.

"We believe there’s a very small risk of transmission through the safeguards we have in place," said Newman to reporters.