The story begins in 2011, when a young Florida man died of brain inflammation from an unknown cause, and organs from his body were transplanted into four recipients. Fifteen months later, a Maryland man died of rabies, and now it turns out to have come from the transplanted kidney he got from the Florida donor. The question now is, could anything have been done to prevent this tragic outcome?
The Centers for Disease Control and Prevention just confirmed the link after DNA testing matched the disease in the two victims. The recipient received his transplant at Walter Reed National Medical Center in Bethesda, Maryland and just died at the Veterans Hospital in Washington, DC.
Organ donation officials stress that rabies is extremely rare — you can count the number of human deaths in the United States each year on one hand. The other problem is that there is no simple test that can be done quickly enough to get an answer while the organ being transplanted is still viable.
But why would anyone take organs from a donor who died of a mysterious brain infection like encephalitis, as this donor did?
Even that question has no easy answers.
A takeout by Betsy McKay in the Wall Street Journal reports that symptoms of encephalitis can be hard to distinguish from other causes. This is according to Dr. Michael Green, chair of the disease transmission advisory committee for the United Network for Organ Sharing. Dr. Green, a professor of pediatrics and surgery at the University of Pittsburgh School of Medicine, told Ms. McKay:
“If you knew someone had encephalitis, the recommendation would be to be extremely cautious before using any organs. The problem is identifying everyone who has encephalitis.”
The Journal report said that seven disease transmissions are reported for every 5,000 donations, and death is very rare.
The other three recipients of organs from the infected donor are being treated and are reportedly doing okay.
UNOS is urging closer scrutiny of potential organ donors for encephalitis, which it says has been underecognized in donors but is highly transmissible.