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HIV transmitted in donor kidney; screening changes urged
March 17th, 2011
04:48 PM ET

HIV transmitted in donor kidney; screening changes urged

Routine lab screening of organ donors for human immunodeficiency virus, introduced in 1985, has made transmission of HIV through organ donation rare in the United States.

So it was surprising when the New York City Department of Health reported a potential kidney transplant-related case of HIV, even though the living donor had been monitored. By looking at the circumstances behind the 2010 New York case, investigators found there were better ways to screen living donors. Researchers noted that in order to reduce the risk of transmission of HIV through living donor organ transplantation, transplant centers should screen these living donors for HIV as close to the time of surgery as possible, using sensitive tests for both chronic and acute infections.

A report on the case, published Thursday by the Centers for Disease Control and Prevention, also urged that clinicians inform transplant candidates of the potential risk for disease transmission, especially when it comes to HIV, and make sure donors know during their initial visit that they are obligated to avoid any behavior that could put them at risk for developing HIV, before they donate their organs.

The report recommended that all prospective living donors have initial serologic tests for HIV with repeat testing as close to the time of organ donation as possible, but no longer than seven days before the organ donation. And that during the initial testing, donors should be cautioned not to engage in risky behavior that could lead to infection with HIV.

Investigators added when living donors with a history of specific behaviors such as high-risk sexual activity and intravenous drug use are identified, they should be closely monitored and counseled on specific strategies to avoid the high-risk activities.

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Filed under: CDC • HIV/AIDS

soundoff (50 Responses)
  1. David Heart

    THE CDC SHOULD TELL HOSPITALS TO TEST TO ACTUAL ORGAN FOR HIV–IN ADDITION TO TESTING THE DONOR.
    After the organ after is removed from the body, hospitals should swab the organ for HIV using the Rapid HIV Test Q-tip: Results will be seen in 20 minutes. Please pass this message on to the entire medical community.

    March 17, 2011 at 19:07 | Report abuse | Reply
    • TNEWT

      David, in your logic of "rapid testing" after the organ has been removed – if positive do you put back in the original donor???? Simply test 2 times at 8 wks & 2 weeks before the procedure....

      March 17, 2011 at 21:44 | Report abuse |
    • Daina

      Is the recipient tested within 7/8 weeks of transplant? One can be dialysis dependent and still be up for acquiring HIV via their own activities.

      March 17, 2011 at 23:59 | Report abuse |
    • scotty

      The HIV Q tip test only tests for the anitbodies not the virus. It can take months for a newly infected person to test positive. How long does it take to test an organ? Will it survive that long out side the body? You seem to have all the answers

      March 18, 2011 at 09:47 | Report abuse |
    • debbie

      I do a lot of rental for client affected by HIV and i noticed a a little while ago when checking their ID that a lot of them were organs donors , i never understood how.

      March 18, 2011 at 14:21 | Report abuse |
    • sammy

      i qot alot of question? i need a good doctor!!!

      March 31, 2011 at 13:19 | Report abuse |
  2. David Heart

    TESTING THE ACTUAL ORGAN–The CDC states that HIV testing for the actual organ is 'not recommended', but an accurate HIV resut can probably be obtained if the organ is tested ImmediatelRIGHT AFTER it is removed from the body: TEST THE ORGAN in addition to Testing the Patient. Please pass thie message on.

    March 17, 2011 at 19:53 | Report abuse | Reply
  3. Captain Hindsight

    Seems like these suggestions (testing the donor for HIV just prior to surgery, counseling on high risk behavior, etc) should have been the norm from the beginning.

    March 17, 2011 at 20:39 | Report abuse | Reply
  4. Todd

    Um, who cares? If you have an organ match, be grateful. HIV can be monitored and treated now. If your kidney fails, fat lot of good it will do for you to wait for one that is HIV-

    March 17, 2011 at 20:52 | Report abuse | Reply
    • Karen

      Um, Todd? If you are an organ recipient who now has HIV that can lead to AIDS, your immunosuppressant drugs that you have to take for the life of your transplant is NOT going to fight all the infections and disease one gets from HIV/AIDS. Death is imminent. If your kidneys fail, you can opt to do dialysis until a healthier organ is available. Please educate yourself.

      March 17, 2011 at 22:42 | Report abuse |
    • Todd

      HIV might kill someone with a donated kidney. No functioning kidneys will definitely kill you though.

      March 17, 2011 at 23:46 | Report abuse |
    • nicole

      uhm i care..i gave my mother a kidney almost 5 yrs ago..and i would so make sure i would not jeopardize her health..r u kidding me? a person, already ill, receiving a kidney, taking medications that weaken their immune system..the last thing that they need is disease-especially HIV..that is not a simple cold..and even with the typical flu, mom has to avoid those who are ill because of her body not fighting infections as good as the typical person bc of her antirejection medication..which btw one of them, is given to HIV patients. a kidney recipient patient-the last thing that they need is a disease..especially HIV..wow i can tell u have never gone through dialysis,,kidney donation or hell and back through complications..geez

      March 18, 2011 at 03:32 | Report abuse |
    • Tif

      My father has been on kidney dialysis for 12 years; upon him receiving a kidney in the near future, I would hope and pray that his donor his tested twice for HIV. It is a scary thought to think that his transplant could result in contracting HIV. Todd: I think you need to do your research about kidney failure. The dialysis machine is a life support system. Some people live long and healthy lives on dialysis... i.e. my father!

      March 18, 2011 at 10:42 | Report abuse |
    • Elizabeth

      What an ignorant post!

      March 18, 2011 at 13:39 | Report abuse |
  5. TNEWT

    David, in your logic of "rapid testing" after the organ has been removed – if positive do you put back in the original donor???? Simply test 2 times at 8 wks & 2 weeks before the procedure....

    March 17, 2011 at 21:42 | Report abuse | Reply
    • skarrlette

      How about when it comes back positive throwing in the trash, DO YOU want a HIV infected organ sir? After you have waited years to finally feel alive again, maybe safe, you find out now you have HIV? Then you have to take crippling HIV coctails for the rest of your life, AND the immune suppresant drugs for the rest of your life because his immune system will be compromised how does that work with a disease that destroys someones immune system? The guy will be lucky if he can make it through the day.

      Test, test and re test, god what is the big deal? Why is there always so much resistance to things that makes sense? Everyone thought at one point HIV was just a gay disease too, remember the Reagan admin wouldn't test for it and wouldn't acknowledge it that helped alot of people didn't it?

      I mean honestly lets cut the BS!

      March 20, 2011 at 13:03 | Report abuse |
  6. Nina

    I care. HIV is still not curable. I do not need another disease to be added to my weaken body. You do not need a new kidney because you are healthy you need one because you are very sick.

    March 17, 2011 at 21:42 | Report abuse | Reply
  7. Jaimie Sirovich

    re "If you have an organ match, be grateful. HIV can be monitored and treated now. If your kidney fails, fat lot of good it will do for you to wait for one that is HIV-"

    If you have an organ transplant you're on immunosuppressants for the rest of your life typically.

    Immunosuppressants in the context of HIV are not a good thing. It will kill you.

    March 17, 2011 at 22:09 | Report abuse | Reply
  8. Jeff

    TNEWT, who cares what they do with it? The point is that the recipient won't get HIV. If the patient is up against death, he/she can opt to receive the organ anyway.

    March 17, 2011 at 22:30 | Report abuse | Reply
    • kirstyloo

      While your comment is more true about a heart or liver transplant, kidney transplant can often be delayed through additional dialysis. On that note, I'd wait a week, month, or a year to get an HIV-negative organ.

      March 18, 2011 at 15:57 | Report abuse |
  9. Stephannie

    I feel awful for anyone fighting HIV.. it`s a horrible disease that kills both slowly and painfully. To think there are those who contract it through a proceedure that`s meant to be life saving is even more tragic – if that`s even possible. I am on a donor list and have been for the last 8 years. I don`t practice or participate in risky behaviors.. Never used IV drugs.. never been promiscuous. Even so, I have an HIV test every year due to my profession. Mainly just for my own piece of mind but still! It`s personal responsibility.. I owe that to others and myself. I now have Hypoglycemia and have no idea how that affects my status as a donor. I would never however, offer a organ to someone else until I knew.There`s no easy answer to the situation. One thing is clear though – we can`t afford anymore of these tragidies.

    March 17, 2011 at 23:16 | Report abuse | Reply
    • Daina

      What profession are you in wherein you're unable to spell 'peace of mind' correctly?

      March 17, 2011 at 23:55 | Report abuse |
    • Diane

      Stephannie – your response was so heartfelt and so true. This was a very preventable tragedy, and completely heartbreaking for the recipient. I am sure you are a strong enough person to overlook the ignorance of others (i.e. Daina). Many prayers and love to you, and good luck!!!

      To Daina: You obviously have no heart and no soul. Only a sociopath would put a response like yours to someone in Stephannie's situation. Apparently you are: A) Uneducated in social etiquette, B) Bored, and have nothing to do but spread your vitriolic messages around, or C) Are yourself HIV+, and must spread your hate.

      Shame on you. You are the only one who will have to live with your negative output to the world.

      March 18, 2011 at 01:38 | Report abuse |
    • Mar

      Well said Diane.

      Daina, get lost.

      Stephannie, that was a beautiful comment. I wish all people could be as kind and heartfelt as you. The world would be a much better place. Keep it up. 🙂

      March 18, 2011 at 10:14 | Report abuse |
  10. heather

    why are they accepting donors that are iv drug users? wouldn't it be sensible to only take donors that are not engaging in high risk activities?

    March 18, 2011 at 04:46 | Report abuse | Reply
    • Zeppelin

      They'll accept straight individuals who are promiscuous or IV drug users, but still would reject a single, celibate gay person. Figures.

      March 18, 2011 at 09:02 | Report abuse |
  11. Dave

    We's b growin ears on mice n junk, changin up da DNA wit all these hybirds blood animals like cows wit human blood, When we be usin dis technology? It be costin too much or just some ol bs for scientist to be runnin they mouf?

    March 18, 2011 at 06:59 | Report abuse | Reply
    • ser

      ummmmmm......what is that?

      March 18, 2011 at 12:06 | Report abuse |
  12. Dave

    We got this guy "Not Sure" and he’s going to fix everything

    March 18, 2011 at 07:02 | Report abuse | Reply
  13. chuchingirl

    how do you make sure is not the recipient that had it from before or got infected after the transplant???......the virus can "come out" years after being infected.......interesting topic

    March 18, 2011 at 09:55 | Report abuse | Reply
    • delphina2

      Actually, that is not true. The vast vast majority of people will test positive no more than 3 months after infection, and the very rare case maybe up to 6 months or so. It never takes years to show up in today's tests.

      March 18, 2011 at 11:52 | Report abuse |
  14. Just My Opinion

    I would never receive a blood transfusion or a donor organ.

    March 18, 2011 at 10:54 | Report abuse | Reply
    • scotty

      even if you were going to die?

      March 18, 2011 at 11:21 | Report abuse |
  15. Justin

    There is a scenario that happened not too long ago where an HIV+ person had cancer and needed a bone marrow transplant. After the transplant had taken place, they can no longer find the cancer OR the HIV. Isn't that a remarkable stepping stone for a cure to HIV, and possibly cancer? When you think about it, HIV is a virus, like the common flu is a virus, and we have a shot for that. I don't understand how drug companies haven't figured out a cure for it yet... or maybe it's because they make WAY too much money on HIV medication that they don't want to search for a cure for it.

    March 18, 2011 at 12:08 | Report abuse | Reply
    • Benny

      @ Justin: The "cure" for HIV you're referring to was specific to that unique case. Timothy Ray Brown had HIV and a cancer of the blood and bone marrow. He underwent chemotherapy to kill healthy and cancerous cells in his immune system, blood, and bone marrow. He was "cured" because he received a bone marrow transplant from someone who had a genetic mutation that makes them resistant to HIV. The bone marrow had to be specifically matched to Brown (meaning it had to come from someone close like a relative) or his body would have rejected the transplant. The problems is (a) bone marrow transplants are dangerous procedures that doctors don't take likely (b) bone marrow donors with the genetic mutation for resistance to HIV are extremely rare (only 1% of the European population carries the mutation), and the odds that these donors will be matches for sick patients are close to zero. So unfortunately this method won't work for the general population.

      March 18, 2011 at 12:36 | Report abuse |
    • Benny

      Oops, I meant to say "doctors don't take the procedure lightly." Moreover, i think you've simplified the science too much. We might have a shot for the flu but we don't have a shot for the common cold, ebola, sars or other viruses. As a scientist actively working in drug discovery and development I adamantly want to see a cure for the world's diseases...but its simply not as easy as you make it sound.

      March 18, 2011 at 12:52 | Report abuse |
    • Justin

      @Benny: I understand the whole situation, as I've read many articles on this case. I was simply stating that there might be a stepping stone with this particular case towards a universal cure for HIV, however, I know how much the drug Atripla costs every 30 days (Walgreens charged $2,000.00) so you can't tell me that insurance companies aren't making a profit off the medicine. Since they're making a profit, why should they research a cure for it? Sounds fishy to me...

      March 18, 2011 at 12:55 | Report abuse |
    • kirstyloo

      While this did work in this case, this was tried in other individuals and the results weren't good. Some died from the transplant and most were still left with HIV/AIDS and a transplant compromised immune system. If drs knew why this case was different, it would be a potential treatment. Because they don't, it's not worth the risk.

      March 18, 2011 at 15:51 | Report abuse |
  16. Elizabeth

    The sad thing is that many, if not most, live donors know the recipients. I couldn't imagine engaging in a behavior that puts one at a high risk for contracting HIV and then going ahead with donating a kidney to anyone, let alone someone I knew and loved.

    March 18, 2011 at 13:43 | Report abuse | Reply
    • kirstyloo

      I fully agree with you, but I don't know if people really think that their at risk. About a decade or so ago, people used to ask friends, family and church members to donate blood for certain procedures because they'd be "safer" than the general donor pool and less likely to have HIV. Strangely enough, these "special" collections had the same rate of HIV and other blood-borne pathogens that the general pool does. I think that there is signficiant denial that someone is doing something at risk for HIV.

      March 18, 2011 at 15:53 | Report abuse |
  17. Savanna

    People, I'm a nurse in the operating room. And I'll tell you right now - swabbing the organ with the rapid HIV swab will do NOTHING. Because it is a swab that tests SALIVA. Sure, you can swab a patient's mouth before surgery so you don't remove a kidney from a potential HIV+ donor, but the swab also only tests for HIV type 1 antibodies. So if the patient has another form of HIV, a negative HIV-1 test isn't beneficial anyway. There is another swab that can test for HIV type 2 and can also test blood; however, it can take up to six weeks (or even longer!) for HIV antibodies to show up in a person's body. However, if this test comes up positive then full blood tests must be done, thus delaying surgery for the organ recipient. The best thing that doctors can do is thorough evaluation of any of the donor's possible risky behaviors as well as blood tests at 8 weeks and 2 weeks prior to surgery. Which is what most facilities do anyway.

    March 18, 2011 at 21:40 | Report abuse | Reply
    • mickael

      100% right. Unfortunately there will always be bad outcomes with even the best testing- which is what is done. David- the only response for your ridiculously uninformed and unintelligent post would be the same response happy gilmore recieved after the final debate; "may God have mercy on your soul"...

      March 18, 2011 at 23:23 | Report abuse |
  18. tag

    Actually, just having the organ donor on your license does not mean you are a donor, it only means you give consent; only 1% of people who die actually qualify for organ donation and about 4% for tissue donation. And it is against the law to have a tissue or an organ donor who has HIV, so no, you cant accept an organ that has HIV, it's completely illegal. And there are two HIV tests out there. One is the HIV 1 & 2 antibody test that checks if you have HIV past usually the 6 month mark. There is also an HIV test call the HIV NAT test that is a PCR test that can determine if you have HIV within 2 weeks of catching it. However, there is a 2 week window between catching it and when that test can actually see if you have it. My source-I work for an OPO(organ procurement organization) and I regularly screen and allocate and deal with organ and tissue donors every day that I work.

    March 19, 2011 at 18:14 | Report abuse | Reply
  19. cindy

    Donor tests pre transplant surgery are very important. So is the biopsy that is done the day of the surgery just before
    the donor kidney is removed. Our family has six people with kidney transplants. Our son had his done at a hospital in
    Cleveland. The donor, we found out later had evidence of once having hep.B and epstein barr sydrome. The donor
    biopsy was forgotten. The kidney was injured and died inside my son and the donor was injured. There seem to be no
    rules that need to be followed when it comes to doctors and transplant surgeries. They are protected by the organizations that you are instructed to contact with complaints. see http://www.kidneytransplantkiller.com

    March 20, 2011 at 10:23 | Report abuse | Reply
  20. Shrebbard

    What the %&LL, you mean with all the knowledge that we have in modern medicine, they are NOT testing for HIV??? I'm not a rocket scientist, but I certainly would expect the donor and the organ to be tested. Testing should have started years ago concerning this issue.

    March 20, 2011 at 15:34 | Report abuse | Reply
  21. David Heart

    DONORS MUST BE TESTED FOR HIV ON THE DAY OF ANY ORGAN DONATION–AND THE ACTUAL ORGAN SHOULD BE TESTED AS WELL AFTER REMOVAL–using ANY testing method that will yield a result of someone very recently infeced with HIV. THIS IS COMMON SENSE.

    March 21, 2011 at 10:14 | Report abuse | Reply
    • scotty

      @David You are basically talking about something you do not understand and making a fool out of yourself

      March 21, 2011 at 10:52 | Report abuse |
  22. David Heart

    DONORS MUST BE TESTED FOR HIV ON THE DAY OF ANY ORGAN DONATION–AND THE ACTUAL ORGAN SHOULD BE TESTED AS WELL AFTER REMOVAL–using ANY testing method that will yield a result of someone Very Recently infeced with HIV. THIS IS COMMON SENSE
    ....If Someone is Tested 2 weeks prior the donation– they could have just been infected a short while prior but still show a Negative test result That Day: But that same person will test Positive On The Day of Donation! TEST ON THE DAY OF DONATION– in addition to 2 weeks prior.

    People who fight this common sense idea are like the same people who believed it was Not necessary for doctors to wash their hands in the Middle Ages before surgery, therefore killing millions of people during that time. People Always fight innovation and common sense practices that pushes civilization Forward.

    March 23, 2011 at 09:51 | Report abuse | Reply
  23. Savanna

    David, you really don't know what you're talking about. Spend some time in the operating room and then maybe you'll have a clue.

    March 25, 2011 at 19:43 | Report abuse | Reply
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