HIV infections from donated organs raise concerns

CHICAGO – A case in which a high-risk organ donor infected four patients with hepatitis and the virus that causes AIDS has led medical ethicists to warn that patients need to know more about whose organs they’re getting.

Public health officials said Tuesday the Chicago case is the first known instance of HIV transmission through organ transplants since 1986.

It’s also the first ever known instance in which one organ donor has spread hepatitis C and HIV at the same time, said Dr. Matt Kuehnert of the federal Centers for Disease Control and Prevention.

The CDC and other public health officials are investigating the Chicago cases.

But they emphasized that the risk of getting any disease from transplanted organs is less than 0.01 percent. Noting that more than 400,000 transplants have occurred nationwide in the past two decades, they called the transplant system safe.

But it’s not 100 percent safe: Standard testing failed to detect HIV in the Chicago case. People waiting for organs should be told as much pertinent information as possible about potential donors, said University of Pennsylvania medical ethicist Art Caplan.

Transplant surgeons generally decide what information is given to patients and their families. Sometimes it’s not much because of the circumstances – patients are very sick, organs are scarce and usable for only a short time, Caplan said.

It’s not clear why the donor in the Chicago case was considered high-risk, or how much the four patients were told. But University of Minnesota ethicist Jeffrey Kahn said it underscores the importance of the consent process “and an individual’s right to decide what’s right for them.”

The four patients got their organs in January at Northwestern Memorial Hospital, Rush University Medical Center and the University of Chicago Medical Center. Two had their operation at the University of Chicago hospital.

The cases came to light within the past two weeks after one of the patients was evaluated for a possible “re-transplant” and had blood tests, the hospital said.

A screening questionnaire revealed that the donor had engaged in high-risk behaviors, said Alison Smith of Gift of Hope Organ & Tissue Donor Network, the Elmhurst, Ill., group that procured the organs. She declined to elaborate, citing privacy concerns.

The hospitals were told that the donor was high-risk, but none would say what information was relayed to the patients or their families.