Organ Recipient Gets HIV: Hospitals Need to Consider Stricter Guidelines

Hospital protocols for organ donation are being reviewed after a recipient contracted HIV from a live kidney donor in a New York City hospital.

According to a health department spokeswoman, this is the nation’s first documented case of HIV transmission via a transplant from a living donor since 1985 when a sensitive test for the virus was approved and implemented.

The hospital followed acceptable protocols in an initial screening of the donor, but the donor apparently had unsafe sex after the test and prior to donating the organ.

“Of course this is a rare case, but we felt like we needed to alert centers to this possibility so they can talk to potential donors about risks and do testing closer to the time of surgery,” the spokeswoman said.

I believe it is crucial for hospitals to begin following the guidelines suggested in a new advisory from the health department, which recommends that hospitals test donors for HIV and the hepatitis C and B viruses within 14 days before the organ donation by using nucleic acid testing.  NAT is able to detect viral infections weeks to months before antibodies are detectable by standard blood tests, which can minimize the risk of accidental disease transmission such as what happened in this particular case.

The test has not been recommended for testing organs from deceased donors because a top priority of doctors is to transplant the organs before they deteriorate, but this time restriction should not apply to living donors, according to an advisory released by the state.

The state is also advising hospitals to question living organ donors about risky behavior, such as the use of injectable drugs. It is not mandatory for hospitals to comply with this recommendation, but the department is urging all centers to update screening policies as necessary.

While these new procedures may seem obtrusive, or time-consuming for hospitals, I think that it would be wise for medical personnel to follow them as closely as possible.

It could prevent horrifying cases like this one, where a patient came in for a life-saving procedure, and came out with a life-threatening infection.