Tuesday, April 08, 2008

US deaths prompt organ donor fears

From ABC in Australia:

Reporter: Emily Bourke
MARK COLVIN: News that donated organs contributed to the deaths of two people in the United States may have done some damage today to the campaign to improve the rates of organ donation here.

A New York teenager was diagnosed with bacterial meningitis and after his death, his organs were donated to four different people. It was several weeks after his death that an autopsy revealed the boy had in fact died of a rare form of non-Hodgkins lymphoma.

Within months, two recipients of his organs, died from the same blood cancer. Australian health authorities say the case is extremely unusual and it should not deter Australians from donating organs.

Emily Bourke reports.

EMILY BOURKE: In March of last year 15 year old Alex Koehne was admitted to a New York hospital suffering from what doctors thought was bacterial meningitis. He was treated with antibiotics but deteriorated and died within weeks. In keeping with his wishes, his parents decided to donate his organs.

MRS KOEHNE: It was very important to us…

MR KOEHNE: Very important to us.

MRS KOEHNE: …Because ever since he was a little boy Alex knew what he wanted.

EMILY BOURKE: Weeks later the results of an autopsy found Alex Koehne had died from a rare form of lymphoma. But by then, his liver had been transplanted into a 52-year-old man, while his pancreas went to a 36-year-old woman. Within months, both of recipients died after developing lymphoma.

MRS KOEHNE: When we found out that they had died our hearts went out to them.

EMILY BOURKE: The donated kidneys went to two different men and both are still alive after they underwent chemotherapy and the diseased kidneys were removed. Lewis Teperman is the director of transplantation at New York University Medical Centre where two of the transplants were done.

LEWIS TEPERMAN: We're alerting people to the fact if someone calls a death from bacterial meningitis and there is no bacteria we are saying, you know what let's back off for a little bit and reconsider if we going to use these organs.

EMILY BOURKE: Professor Jeremy Chapman is from the International Transplantation Society. He says the American case is cause for concern but not alarm.

JEREMY CHAPMAN: If we have any suspicion of a malignancy of this sort in a donor we would go for a biopsy immediately or we would default to not proceeding with the donation.

EMILY BOURKE: How common would this type of transplant be from someone who presented with an illness, bacterial meningitis, but it turned out to be something else?

JEREMY CHAPMAN: It's uncommon but not zero. So in Australia in the 1980s there was a donor with a lymphoma. I looked after one of the recipients of that of one of the kidneys. We did exactly what they've done here and that is took the kidney out straight away. So they do happen, but they don't happen very often.

EMILY BOURKE: Professor Bruce Pussell is the head of the Transplant Unit at Sydney's Prince of Wales Hospital. He says that risk of contracting an infection or disease from a donated organ is far greater for those who travel overseas for their transplants.

BRUCE PUSSELL: Well in depends entirely on the country that you go to and the screening procedures that are in place in that country. We've been advising our patients to take with them the protocol that we've developed for screening donors here and to ensure that those people are protected in some way. That's if they insist on going.

We would strongly advise them not to go of course because of the risks involved and they are serious. I think that the survival rate of those patients was only about 50 or 60 per cent compared with Australia where the patient survival is well and truly 97 or 98 per cent. So there's a big risk that they are carrying of death or disease otherwise.

EMILY BOURKE: And Professor Chapman from the Transplantation Society says the American experience should not deter potential Australian donors or recipients.

JEREMY CHAPMAN: Nothing is ever 100 per cent safe. You can't cross the road 100 per cent safe and unfortunately transplantation is like that. And that is why we have very highly-trained professionals in the transplant programs and in the intensive care units in Australia to ensure that it is as safe as it can possibly be.

MARK COLVIN: Professor Jeremy Chapman from the International Transplantation Society ending Emily Bourke's report.

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