Organs

Four transplant patients in Chicago have contracted HIV from the organ donor. It is alleged to be the first case of such transmission in the U.S. in 13 years.

Initial tests on the donor for HIV, hepatitis and other conditions came back negative, most likely because the donor had acquired the infections in the last three weeks before death. Personal details about the donor were not released [to the recipients or their doctors] by medical official [sic] officials, who cited privacy laws.
Emphasis added.

The screening process has, granted, been (apparently) successful in preventing tissue transplant transmission of HIV for 13 years. And for a long time, available tests for HIV had a significant window period, during which HIV is present, but undetectable by the test. Antibody tests generally have a three week window period. That means that, if a donor donates organs within three weeks of initial infection, an antibody test will not detect the virus. New tests, which directly test for the presence of viruses or virus fragments, commonly called PCR tests (after the method, polymerase chain reaction), but more accurately termed NATs (nucleic acid tests), have a window period of less than two weeks. This is the test used for screening donated blood. These are more time-consuming, labor-intensive, and expensive tests than antibody tests, so blood banks pool samples from multiple donors and test the pool. A positive result will either invalidate all the donors in the pool, or lead to further, individual testing of the donated blood, depending on need.

Clearly, this is not the method that was used in this case. The article indicates a window period of 3 weeks, suggesting an antibody test. That in itself is suspect. But my point, to which I am coming shortly, is not to criticize the organ screening methods. I am not suggesting that the government step in with stricter standards requiring (or paying for, with stolen tax dollars) more advanced tests. That won't help anyone.

Observe what horrors arise when the government bans the voluntary sale of organ tissue.

These patients were prohibited from knowing the identity, lifestyle, or medical history of the donor. They were not presented with the evidence. They were not permitted to weigh the relevant risks. Because of Federal "privacy laws." Nor did they have the opportunity to purchase organs from a more transparent source. In fact, tissue recipients are not permitted to "shop" for the best quality organ. No choosing what organ to accept based on what HIV test was used. No choosing what organ to take based on the lifestyle or manner of death of the donor. No opportunity to weigh the risks against the benefits and make an informed decision. And certainly no opportunity to pay more for a better organ. It might be true that, as the article suggests, the screening system cannot be made perfect. But there is no excuse for hiding any potentially relevant information from the patient, including screening methods and personal information about the donor.

The donor system amounts to blackmail. Transplant patients are presented with an empty choice: Either play Russian Roulette with the donor system, or die.

Tom G Varik