Donors neurological problem makes recipients ill

The plight of two kidney transplant patients who contracted a brain infection from an organ donor is prompting US health officials...

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The plight of two kidney transplant patients who contracted a brain infection from an organ donor is prompting US health officials to re-examine their policies on using people with certain neurological conditions as donors.

The organ donor,a child at the University of Mississippi Medical Center in Jackson,had had seizures and a brain disorder initially thought to be an autoimmune disease and not transmissible. The real cause of his illness turned out to be a rare,usually fatal infection,but the mistake in diagnosis was not recognised until the transplants were done and the two recipients had become critically ill.

The case highlights the lack of a national policy on whether to bar people with poorly defined neurological disorders as donors.

For now,the decision is up to individual transplant centers,said Dr Michael G Ison,chairman of an advisory committee on infectious disease transmission for the United Network for Organ Sharing,which coordinates transplants in the United States.

Dr Ison said,The bigger issue is that in cases in which a patient has a neurologic condition that hasnt been definitively diagnosed,that is associated with altered mental status,most experts would recommend against the use of organs from those donors. Dr Ison said the Mississippi case spurred him to begin looking at nationwide data to see how often such patients become donors.

Dr Shirley Schlessinger,the medical director for the Mississippi Organ Recovery Agency,said that the university had done extra tests to see if the organs were safe to transplant. This will be discussed by a collaborative group of experts at a national level to try to make the system safer,Dr Schlessinger said. But she added,I think its wrong to say were going to eliminate all these people we cant be sure of. There will always be undetectable disease in the setting of solid organ donation. We have to stratify the risk and present it to recipients.

Disease transmission from transplants occurs in 1 per cent of cases involving deceased donors,according to data the organ network began collecting in 2005.

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Recipients have contracted West Nile virus,rabies,HIV,tuberculosis,a rodent virus,parasitic worms and other infections. In a few cases,donors have even transmitted cancers.