Federal and local officials are investigating whether four Chicago patients who contracted HIV from organ transplants passed on the disease during the months when they were unaware of their infections, health officials said yesterday.
The four patients contracted HIV and hepatitis C from an infected donor in January, and they did not know of the potential risk to their partners and close contacts until they tested positive for the diseases in the past two weeks. The infected donor had not tested positive for the diseases, likely because the infections were too recent to register on screening tests, officials said.
The risk to others could have been reduced had the hospitals tested the organ recipients soon after their transplants, said Dr. Matthew Kuehnert, director of blood, organ and tissue safety with the federal Centers for Disease Control and Prevention. Kuehnert said he was concerned that none of the affected hospitals - Rush University Medical Center, Northwestern Memorial Hospital and the University of Chicago Medical Center - appeared to have followed CDC guidelines for testing at-risk patients after a transplant.
Although investigators have established that no one else got contaminated organs or tissue from the donor, it's too soon to say whether the organ recipients passed on the infections to anyone else, Kuehnert said.
"That's part of the public health investigation," Kuehnert said. "It's something that we're concerned about, and we're asking questions through the [Chicago] health department."
A spokesman with the Chicago Department of Public Health said that the investigation is continuing and that there is no evidence to suggest that the organ recipients have spread the disease.
The organ donor had engaged in high-risk behavior, officials said, meaning that the transplant recipients should have been tested for HIV three months after their operations, even though the donor's initial HIV test was negative. That three of Chicago's biggest hospitals failed to follow the CDC testing recommendations after the transplants might suggest that few institutions took the risk of transmission seriously enough before now, Kuehnert said.
"It's hard to know how often recipients who get organs from high-risk donors are tested," Kuehnert said.
The cases have reopened the issue of how to protect organ recipients from disease while ensuring that they get needed transplants, federal officials said. Many experts believe the infections show that organ programs should follow the lead of blood and tissue banks, which employ more extensive screening that has less chance of inaccurate results.
But applying their techniques to organ donation could be difficult because organs can be stored only for a short time - as little as four hours for hearts and lungs.
Jeremy Manier writes for the Chicago Tribune.