News: NYC Patient Contracts AIDS From Donor Kidney
(Long Island, N.Y.) A patient at a New York City hospital contracted the HIV virus after receiving a kidney transplant in 2009. The patient found out a year after the transplant, in which the organ was obtained by a live donor. Health authorities say that the donor exposed himself to the virus that causes AIDS while having unprotected sex with another man.
Though the donor had been tested for the HIV virus ten weeks prior to the transplant surgery, his results came back negative. Health authorities believe that it’s within that ten week time frame that the donor contracted the virus. He admitted to having participated in behavior that put him at a greater risk for infection.
Many believe that the screening policies of live donors are in need of improvement. There are currently no strict policies regulating when a donor should be tested for diseases prior to a transplant surgery. The Center for Disease Control recommends the tests be preformed within a week of the surgery, but policy making is left to the individual transplant centers.
The types of testing could also be a factor in better screening policies for donors and patients. HIV and AIDS testing began in 1985, and since then, a more sensitive test has been constructed. In the 1990s a test was developed that could detect the presence of HIV antibodies within ten days after exposure to the HIV virus. The traditional test, which is more commonly used, can only detect antibodies after three to eight weeks of exposure.
This is the first reported and confirmed case of transmitting HIV through an organ transplant since the 1980s throughout the country. A similar case in 2007 also involved a kidney transplant and a woman from Orlando, Florida who claimed she had been infected after the surgery. The Center of Disease Control was never asked to investigate the Florida hospital involved in the case, and therefore could not confirm the report. A similar case in Italy was reported in 1989.
While both are receiving treatment for the virus, the recipient in this case developed AIDS while the donor did not. It’s possible that the immune-suppressing drugs given to the recipient at the time of the transplant increased chances for the virus to be effective. Immune-suppressant drugs are giving to patients receiving transplants so that the new organs are not rejected.
A misconception involved in organ screening is that the donor doesn’t need to reveal whether they have used drugs, participated in unprotected sex, or have behaved in a way to increase risk of infection. Because donors are often relatives and friends of the recipients, their desire to help and maintain their privacy keeps them from coming forward with information. Many believe that the tests will be enough to keep them from transmitting any diseases.
Another reason for the lapses in screening for live donors could be due to the increasing number of live donors over the years. Originally, the transplant system relied mostly on organs of the deceased, which were vigorously tested for HIV, hepatitis, and other diseases. Over the years the number of live donors has increased; 32% of kidney transplants were from live donors in 1988 compared to 46% in 2010. There are currently 88,000 people in the country awaiting a kidney transplant.
In 2007 a case in Illinois surfaced about the transmittance of HIV through the organs of a deceased donor. The donor was a thirty-eight-year-old gay man who had donated organs to four different recipients. Months were spent investigating the NYC patient in this case to confirm that the AIDS originated from the transplanted kidney.
