Feds Help Illinois HIV Transplant Probe

Federal officials are investigating what three hospitals knew and told four organ transplant patients about a high-risk donor who infected them with HIV and hepatitis.

BY Matthew Van Atta

November 20 2007 1:00 AM ET

Federal officials
are investigating what three hospitals knew and told
four organ transplant patients about a high-risk donor who
infected them with HIV and hepatitis.

The
investigation's new phase involves the federal Centers for
Medicare and Medicaid Services, which oversees organ
procurement programs and hospitals nationwide.

The stakes are
high: If the agency finds any mishandling and the
hospitals don't comply with any demands for corrective
action, the hospitals could face penalties. The worst
would be being ousted from Medicare participation,
meaning a loss of crucial federal revenue.

The case
disclosed this week is the first known instance of HIV
transmission through organ transplants since 1986, and the
first time HIV and hepatitis have been spread
simultaneously from one donor to transplant
recipients, public health officials say.

While Medicare
officials generally contract with local authorities to
investigate hospitals, this time the agency has sent
officials to Chicago to assist investigators from
Illinois's Department of Public Health, said Jan
Tarantino, director of the agency's division of continuing
care providers. ''We're taking some extra steps ...
because this is potentially a very serious
situation,'' she said Thursday.

Hospital and
public health officials have called the case a tragedy, but
emphasize that the risk of getting any disease from
transplanted organs is less than 0.01%.

Tarantino said
officials from her agency last week visited the Elmhurst,
Ill., group that procured the organs, Gift of Hope
Organ & Tissue Donor Network. This week they
started questioning authorities at the three
hospitals, Northwestern Memorial Hospital, Rush University
Medical Center, and the University of Chicago Medical
Center.

''We're looking
at the circumstances surrounding the donor and the four
recipients and checking to make sure that all the
notifications'' took place, Tarantino said.

None of the
hospitals has said publicly what patients were told, citing
doctor-patient confidentiality. They also have declined to
identify the donor, the patients, and what organs they
received, citing privacy concerns.

Gift of Hope
officials have said they followed proper procedures before
the January transplants by notifying all three hospitals
that the donor had engaged in high-risk behaviors.

Attorney Thomas
Demetrio filed a petition Thursday in Cook County circuit
court on behalf of an infected female patient, asking
officials to keep the University of Chicago and Gift
of Hope from destroying or altering any records
involving the donation. The patient received a kidney
transplant at the University of Chicago Hospitals on January
9, Demetrio said in a statement.

Gift of Hope and
the University of Chicago both knew the kidney donor was
high-risk and did not inform the patient, according to the
petition.

''It is
imperative that we secure any and all records and
information pertaining to this transplant surgery and
the kidney donor in order to properly protect the
legal rights and interests of our client,'' Demetrio
said.

Federal
guidelines say patients are supposed to be notified about
the possibility of HIV infection from a high-risk
donor even if tests show the donor doesn't have the
virus.

Standard tests
for HIV and hepatitis antibodies showed the donor didn't
have those diseases. Authorities say the donor probably
acquired the infections a few weeks before death, too
soon for the tests to detect antibodies.

A newer, costlier
test that is not widely available can detect the virus
earlier but wasn't done in this case. That has led public
health officials to press for more widespread use of
the newer test.

''Hopefully, in
the future it can be the norm,'' said Susan Gerber, chief
medical officer for Chicago's Department of Public Health.

Gerber said her
office is working with the federal Centers for Disease
Control and Prevention, ''trying to find out what
happened.'' That includes examining the circumstances
surrounding when the patients were first tested for
HIV.

CDC guidelines
recommend testing three months after transplants from
high-risk donors. But the University of Chicago said the
patients didn't learn they were infected until after
they had undergone tests within the past few
weeks. That round of testing was prompted by the results of
one of the patient's blood tests taken during an evaluation
for a new transplant.

The CDC's Matt
Kuehnert said Thursday his agency has not sent anyone to
Chicago but is doing laboratory testing on blood samples
from the donor and patients to determine how
responsive the virus is to anti-HIV drugs, which will
help doctors determine the best treatment. (AP)

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