Mother of HIV-infected organ donor feels guilty, contrite

 2011/08/28  Taipei, Aug. 28 (CNA) The mother of an HIV-infected organ donor said Saturday she was shocked and full of remorse after learning that her son's organs had been transplanted into five patients who now face the risk of getting AIDS. "I did not know that my son had contracted HIV. Otherwise, I would absolutely not have proposed that his organs be donated," the woman said with sadness and regret. It marked the first time in Taiwan that organs from a known HIV-carrier were transplanted into patients. A volunteer with a charity group, the Hsinchu resident said she was inspired to propose the organ transfer by the actions of one of her co-workers, who donated her son's organs after he was fatally injured in an accident. "I was touched by such a generous deed, and I decided to follow suit after my son sustained a critical injury to his head after falling from a high spot," she recalled. She took the initiative to contact a doctor she knew at National Taiwan University Hospital (NTUH) to arrange the transfer of her son's organs after a Hsinchu City hospital diagnosed his chances of survival as slim. According to Hsinchu police, the 37-year-old man fell from an aluminum ladder on the roof of a neighbor's house on Aug. 23 while trying to get into his home through its balcony because he forgot his keys. When he was transferred from a clinic to Nanmen General Hospital the following day, he was in a deep coma -- a 3 on the Glasgow Coma Scale -- hospital sources said. Later that day, an NTUH transplant team traveled to the Hsinchu hospital to remove the man's organs for transplant. The heart transplant was performed at National Cheng Kung University Hospital in Tainan in the south and four other transplants -- liver, lung and two kidneys -- took place at NTUH in Taipei in the north. Hung Chien-ching, an attending physician in NTUH's infectious disease department, said Saturday that the four transplant recipients were still recuperating in the hospital's intensive care units. "They remain in critical condition, fighting rejection, and we don't know at this moment whether they have been infected by HIV," Hung said at a news conference. Besides taking anti-rejection drugs, the patients have also been offered emergency anti-AIDS medications, which Hung said would not harm their newly transplanted organs. Citing medical studies, Hung said the transplant recipients would be able to largely inhibit HIV reproduction after taking anti-AIDS drugs for two weeks. "They have to continue taking the medications for at least two months, and it will take an estimated six months to determine whether any of them has contracted HIV," Hung said. He further indicated that NTUH management informed the patients' families on Friday of the AIDS risks their loved ones are now facing. "They were all shocked and stunned," Hung said. "This was a very rare and extremely regrettable case." The HIV infection rate normally exceeds 90 percent for those who get HIV-contaminated blood transfusions, Hung said, and the probability is also very high for those who receive transplants of organs from HIV carriers because the blood in such organs tends to carry the virus. In 1994, Hung said, four transplant recipients in the United States were all tested HIV-positive 10 months after organs from the same donor were transplanted into their bodies. The donor was said to have contracted AIDS shortly before his death, which made it difficult for lab people to detect the virus in the organs before the transplants. Following the rise of "cocktail" therapy for AIDS patients, Hung said, some U.S. studies showed that the functions of transplanted kidneys were not impaired after the recipient took the anti-AIDS "cocktail," a combination of three or more drugs. NTUH spokeswoman Tan Ching-ting said the 10-plus members of the hospital's transplant team would not need to take preventive anti-AIDS medications because none of them had been exposed to blood or body fluids from the donor or patients. "They are not expected to face an AIDS risk and do not need to stop practicing medicine," she said. NTUH management admitted Saturday that its transplant team's failure to follow standard operating procedures (SOP) had led to the embarrassing disaster. Tan said at a news conference that the hospital's physicians did not check HIV test results on the computer before organ transplants as required. "They only checked the results of HIV tests on the organs with the hospital's lab people by phone, leading to a misunderstanding," Tang said. Transplant team members heard a member of the lab say the test results were "non-reactive" when in fact they were "reactive" and proceeded to perform four transplant procedures, Tan said. A fifth organ was sent to National Cheng Kung University Hospital in Tainan, which apparently suffered a similar oversight. Speaking on the same occasion, Hung said the hospital did not know the donor was an HIV carrier. Local health departments, he said, usually do not expose carriers' identities over privacy protection concerns. "Before our team performed the transplants, it had no way to know the donor was an HIV carrier," he said. Local legal experts said that if the transplant recipients are confirmed to have been infected with HIV, they can file civil suits to ask for compensation in accordance with the law. NTUH physicians may also be sentenced to jail for negligence for up to three years, they added. Earlier Saturday, Yao Ke-wu, director of the Bureau of Health of Hsinchu City, said the donor was a legally listed HIV carrier in Taipei, who received treatment there until July before being referred to Hsinchu City for continued care. The NTUH mistake, Yao said, exposed a major loophole in the domestic organ transplant system. The Department of Health (DOH) said the same day that it had ordered NTUH to come up with a detailed report on the incident within three days. The hospital informed the DOH of the case Saturday, said Shih Wen-yi, deputy director-general of the DOH's Centers for Disease Control. Shih said the hospital has apologized to the patients and their families as well as briefed them on the situation. To the best of his knowledge, Shih said, the hospital has consistently conducted HIV-testing on organ donors. "We don't know at the moment what went wrong in this case, which has left five innocent organ recipients facing AIDS risks," Shih said. HIV is a lentivirus that causes acquired immunodeficiency syndrome (AIDS), a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive.