March 25, 2013
When A Rabid Organ Kills
redOrbit published a report about a man who died of rabies. The saddest part of that is that he contracted the rabies when he had a kidney transplant. “The Maryland man died on February 27 and health officials made the rabies diagnosis this month while investigating his cause of death. Upon re-examining the donor’s case, doctors found that person, who was from Florida, had also died of rabies. The CDC said the two viruses were genetically identical, indicating the organ was the source of the Maryland patient’s rabies,” according to redOrbit. The donor died of encephalitis, which is an inflammation of the brain. The donor’s doctors did not know that it was caused by rabies.
Though only a handful of rabies cases are reported (fewer than ten) each year, this still has caused the Centers for Disease Control and Prevention (CDC) to reconsider the approach to testing donors for the disease. Dr. Matthew Kuehnert, director of the CDC’s Office of Blood, Organ, and Other Tissue Safety told CNN that, “What we need looking forward is a standardized approach when you have encephalitis of unknown cause so very important things like this aren’t missed.”
I cannot imagine what the transplant’s doctors and family must be feeling about this whole ordeal. The man received a transplant of his kidney, which must have been failing, thus he thought he was receiving another chance at life. Then 15 months later he is in the hospital again to never leave.
At first, his doctors doubted that the kidney was the cause specifically because 15 months had passed between the transplant and the death. Obviously, the thought of rabies from the transplanted kidney did not initially cross their minds. Rabies usually only incubates for three months, so they did not even consider it.
This just seems like such a sad situation all around. First, the donor died of rabies; only doctors thought it was just encephalitis. Then the Maryland man gets a new kidney only to contract rabies. Doctors now have to deal with the fallout of this situation, some of which will naturally be suspicion toward organ transplant. This latter reaction is the most devastating. Many individuals have very successful transplants with nothing like this happening.
The other really sad part is that rabies only infects about five people a year in the United States. Almost all of those infections come from animal bits, particularly bats, raccoons, and dogs. Yet, the Maryland man died from a medical procedure. Plus, the donor had organs go to three other individuals. None of them have any rabies symptoms, but doctors have started the rabies treatment for them just in case.
In times like this, when something so horrible happens’, I can’t help but wonder how this happened. Rabies is a pretty easy disease to treat, if caught in time. I do not doubt the integrity of most doctors, but if encephalitis is a possible outcome of a rabies infection and someone dies of encephalitis, wouldn’t a doctor check for rabies before harvesting organs to be transplanted to another individual?
I do not know what doctors do when an organ donor dies. I mean, I do not know what they check for in terms of diseases before sending organs off. Maybe Dr. Kuehnert is right; a new procedure might be needed for organ donors who die from encephalitis; or maybe new procedures to thoroughly check organs for any diseases is necessary.
In any case, my heart goes out to all in this tragedy.
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