Posted on 03/26/2006 6:49:13 PM PST by Born Conservative
Josh Hightower needed a kidney. But he was hardly on his deathbed.
In the months before his transplant, the 17-year-old roared across his family's East Texas ranch in his four-wheeler and tossed fluid-filled dialysis bags from his truck like water balloons.
On the night his mother got the unexpected call – there was a kidney for him headed to Baylor University Medical Center at Dallas – Josh was out with his longtime girlfriend, having a high-school-sized argument.
But the organ meant to liberate Josh from a life of catheters and blood-cleaning machines instead caused his death: It infected him with rabies. In all, four transplant recipients and the donor himself died of this rare but highly preventable disease – a medical tragedy that made national news and turned a treasured gift of life into a deadly weapon.
Professionals considered it an anomaly. It was the first reported case of rabies transmission through solid-organ transplant – a statistical aberration that raised awareness and eyebrows at national conferences but didn't fundamentally change how organs are screened in this country.
For Dale and Jennifer Hightower, who still listen for their son's truck to thunder up their driveway in Big Sandy, Texas, and can't bring themselves to delete his voice from the family's answering machine, this explanation is far from acceptable.
They're furious that the same disease they vaccinate their dogs for isn't included in routine organ screenings. And they're heartbroken that transplant surgeons missed the symptoms – the heavy salivation, the confusion, the vomiting and headaches that led to the death of 20-year-old William Beed Jr. in a Texarkana, Ark., hospital, and drove the recipients of Mr. Beed's organs...
(Excerpt) Read more at dallasnews.com ...
This is a tragedy for the families, but the statistical likelihood of contracting rabies from any source is virtually nonexistant.
It is a tragedy, but I agree; it's extremely unlikely that this will happen again, or at least it will certainly not occur on a regular basis. It's just not practical to test every donor for rabies.
There isn't enough information here. How does a human donor pass rabies to an organ recipient? Can humans be infected but asymptomatic "carriers"?
Yes. Reason to shake their fists at God, if that will help them.......but no reason to do a single thing that will delay or prevent transplants for those to come. This is like a freak accident, unless it was known that the donor had rabies before organs were harvested.
To the best of my knowledge, you can't be an asymptomatic carrier of rabies. If you have it, you are going to die (there is one known case of survival, a girl in Wisconsin who received experimental treatment and lived to tell about it). When you are infected with rabies, the virus is present in saliva, and affects the nervous system. This case is extremely unusual. Whenever you accept the organ of another person, you take the chance that an undetected disease may be contained in the organ.
How long does it take to get a positive or negative on the rabies antibodies? It may take longer than the donated organ is viable outside of the donor if taken from a cadaver.
Not sure, although I would think that it's not a test that's run very often, and possibly, the transplant center's lab wouldn't have the equipment to run that specific test. If that were the case, then it would impact the viability of the organ.
Rabies in Transplant Recipients: Organ Transplant Concerns
http://www.cdc.gov/ncidod/dvrd/rabies/ques&ans/q&a_transplants_organ.htm
Thanks for the link. I'm on the transplant list, waiting for a kidney, but I'm not worried about rabies.
Also, I've been a RN for 17 years at a regional tertiary care center in a rural area, and have never seen a case of rabies (although there was a case right before I started my job; the child was transferred to our facility with uncontrolled seizures. It took a day or 2 before the symptoms progressed enough for it to be diagnosed correctly. By that time, the staff had been exposed, and all had to get the Rabies Post Exposure Prophylaxis series of shots).
Following primary infection (see Figure, numbers 1 & 2), the virus enters an eclipse phase in which it cannot be easily detected within the host. This phase may last for several days or months. Investigations have shown both direct entry of virus into peripheral nerves at the site of infection and indirect entry after viral replication in nonnervous tissue (i.e., muscle cells). During the eclipse phase, the host immune defenses may confer cell-mediated immunity against viral infection because rabies virus is a good antigen . The uptake of virus into peripheral nerves is important for progressive infection to occur (see Figure, number 3).
After uptake into peripheral nerves, rabies virus is transported to the central nervous system (CNS) via retrograde axoplasmic flow. Typically this occurs via sensory and motor nerves at the initial site of infection. The incubation period (see figure, number 4) is the time from exposure to onset of clinical signs of disease. The incubation period may vary from a few days to several years, but is typically 1 to 3 months. Dissemination of virus within the CNS is rapid, and includes early involvement of limbic system neurons (see Figure, number 5). Active cerebral infection is followed by passive centrifugal spread of virus to peripheral nerves. The amplification of infection within the CNS occurs through cycles of viral replication and cell-to-cell transfer of progeny virus. Centrifugal spread of virus may lead to the invasion of highly innervated sites of various tissues, including the salivary glands. During this period of cerebral infection, the classic behavioral changes associated with rabies develop.
Signs and symptoms
The first symptoms of rabies may be nonspecific flu-like signs — malaise, fever, or headache, which may last for days. There may be discomfort or paresthesia at the site of exposure (bite), progressing within days to symptoms of cerebral dysfunction, anxiety, confusion, agitation, progressing to delirium, abnormal behavior, hallucinations, and insomnia. The acute period of disease typically ends after 2 to 10 days (6). Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive. Disease prevention is entirely prophylactic and includes both passive antibody (immune globulin) and vaccine. Non-lethal exceptions are extremely rare. To date only six documented cases of human survival from clinical rabies have been reported and each included a history of either pre- or postexposure prophylaxis.
snipped from:
http://www.cdc.gov/ncidod/dvrd/rabies/natural_history/nathist.htm
Apparently not nonexistant.
L
Tragedy yes...lawsuit, no...not going to help the system...
ya, but it wouldn't surprise me if regulators destroyed the whole system in order to prevent this sort of thing.
I was under the impression that only death by trauma released the organs for transplant.
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