Transplant patients risk CJD after receiving tissue from infected woman

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The Independent Online
Transplant experts said yesterday that three patients who received donated tissue from the eyes of a woman suffering from CJD could be at risk of developing the disease.

But they insisted that the benefits of transplants far outweigh the risks, says Jeremy Laurance, Health Editor.

A new threat to Britain's transplant programme emerged yesterday after it was disclosed that a woman who died of lung cancer was later allegedly found to have been suffering from Creutzfeldt Jakob disease after tissue from her eyes had been transplanted into three other patients.

The woman, named by a newspaper as Marion Hamilton, was reported to have agreed to the use of her organs before her death at the age of 53. The corneas from her eyes together with the sclera (the white of the eye) from one were given to three patients. Later, a routine post-mortem examination is understood to have shown that she had CJD.

The Scottish Office said in a statement that it was aware of the "potential infection of eye tissue" taken from a patient. "Immediate action is being taken to increase safety checks to minimise the chances of this happening," it said.

It was unclear last night what these safety checks might be. Robina Balderson, chief executive of the UK Transplant Authority, said doctors had to judge whether a patients organs were suitable for transplant on the basis of the best information available at the time. They could not wait for the result of a post-mortem examination because organs must be transplanted fresh. She said 5,000 patients a year received transplanted organs or tissue and there were 6,000 on the waiting list.

"Every single transplant either saves the life or the sight of a patient. This case is clearly tragic for the family concerned but I would be horrified if it increased the fear of those on the waiting list or reduced the number of donors coming forward."

Doctors are required to follow strict guidelines in deciding whether the organs from a patient who has died are suitable for transplant. Infection with HIV or hepatitis, for example, would automatically rule out that patient's organs for transplant.

Evidence from abroad has shown that CJD can be transmitted via corneal transplants and in other neurosurgical procedures although no cases have occurred in Britain. However, there is no test for CJD and it can only be confirmed by a post-mortem examination of the brain.

Professor Jeff Almond, an expert on CJD and a member of the Government's Spongiform Encephalopathy Advisory Committee (SEAC), said it was by no means certain that the patients who had received the donated tissue would develop CJD. "It could be a very rare event. I'm not aware of any study showing how frequent it is." He said the risks had to be balanced against the benefits of the transplant.

John Dark, transplant surgeon at the Freeman Hospital, Newcastle upon Tyne, said: "CJD is vanishingly rare. There is an element of risk in everything we do in transplant surgery. Compared with the other risks we take, the chances of getting CJD are very small."

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