March 18, 2011
On Thursday, CDC released its report on the case of a kidney transplant recipient who contracted HIV from a living donor in a New York City hospital in 2009.
Neither the donor nor the recipient knew he or she was HIV-infected until approximately one year after the transplant surgery. The recipient's multiple hospitalizations were initially thought to be organ rejection. Then the patient was treated for oral and esophageal candidiasis, and HIV testing indicated a positive result. The recipient's CD4 cell count was found to be under 100. Also about one year post-transplant, the donor sought repeat STD testing with his primary care provider and learned he was HIV-positive. The transplant team became aware of his diagnosis during a one-year follow-up visit.
The donor had reported a previous syphilis diagnosis and a history of male sex partners in his initial transplant evaluation. Testing 79 days before the procedure showed no evidence of HIV, hepatitis B or C infection. However, the investigation revealed he had had unprotected sex with one male partner of unknown HIV status during the one year before the transplant, including the time between his initial evaluation and surgery for organ harvesting.
To prevent and screen for HIV in prospective living organ donors, CDC is recommending the following:
Increasingly, kidney transplants involve live donors -- from 32 percent of transplant surgeries in 1988 to 46 percent last year. Roughly 88,000 people are currently on the kidney waiting list, according to the United Network for Organ Sharing.
The report, "HIV Transmitted from a Living Organ Donor -- New York City, 2009," was published in CDC's Morbidity and Mortality Weekly Report (2011;60(10):297-301). To view the report, visit www.cdc.gov/mmwr/PDF/wk/mm6010.pdf.