Ask tough questions about donor tissueJun 11, 2006 | AP Suppose you need a new knee. Spinal surgery for an aching slipped disc. Maybe a replacement valve for a leaky heart. These procedures often involve parts taken from someone who died. About 1 million such operations are done in the United States every year. Most are safe and successful.
But sometimes those donated body parts can carry dangerous diseases.
HIV, hepatitis, rabies, deadly bacteria and fungus are among the infections that have stricken some who've had tissue transplants in the last 15 years.
And that was before the ghoulish scandal in which a New Jersey company is accused of selling bones and tissue illegally obtained from the bodies of people too old or sick to be donors, including Masterpiece Theatre host Alistair Cooke, who died of cancer at 95.
It's not known whether cancer can be passed on from donated tissue, but Cooke's body was in no condition to be a donor source.
With lax regulation of the donated tissue industry, patients need to protect themselves if they are planning an operation using tissue from a cadaver.
"My focus is to tell people one thing: This can happen to you," said Steve Lykins, whose 23-year-old son died five years ago after a knee operation using donor tissue.
Ask lots of questions:
• If you need surgery to fix bones or tissue, ask whether donor body parts will be used, and whether there are alternatives. Some operations can be done using patients' own bone or tissue, although that's more invasive. Artificial tissue or animal tissue may also be options.
• If human donor tissue will be used, "Look (your) doctor in the eye and say, 'Do you know that this came from a certified tissue bank and that you're comfortable with where it came from?" advises Dr. Stuart Youngner, a medical ethicist at Case Western Reserve University. Companies that are accredited by the American Association of Tissue Banks are required to follow that group's standards, including sophisticated testing for germs.
• Get the names of each company that retrieved, processed and distributed your tissue, and make sure each one is a member of the American Association of Tissue Banks.
• Have surgery done in an institution accredited by the Joint Commission on Accreditation of Healthcare Organizations. The commission has set detailed standards on tissue handling for hospitals and surgery centers it oversees.
Fungus: More than 500 heart valve transplants each year are thought to be contaminated with fungus, leading to an estimated 207 deaths a year.
Hepatitis C: Cases in 1992, 1995 and 2002. More than 40 people received contaminated organs or tissue after an Oregon tissue bank failed to detect the virus in a single donor in the 2002 outbreak. One died, probably as a result.
Hepatitis B: 1954. One tissue transplant.
HIV: 1983 and 1992. Four tissue transplants.
Clostridium, "flesh-eating," and other types of bacteria: November 2001. A Minnesota man's death led to discovery of more than 60 other bacteria-contaminated transplants in 20 states, including some tissues infected with multiple types of bacteria.
Cytomegalovirus, or CMV: Cases have occurred involving donated skin.West Nile virus: August 2002. Several organ recipients developed fever and altered mental status from virus-contaminated transplants.
Rabies: 2004. Three organ recipients and one tissue recipient died after contaminated transplants.
Chagas disease: April 2001. Three people caught this parasite, common in Latin America, from organ transplants from a common donor.
LCMV, a rodent virus: May 2005. Three people died after receiving contaminated organs. Others received tissue from the same donor. Three others died in December 2003 after receiving organs infected with LCMV.
Tuberculosis: 1953. One tissue transplant.
Spread through transplants
Many viruses, bacteria and other germs have spread to people through transplants of tissue from cadavers or organs from live donors.