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Can you get sick from a transplant?

The body views transplanted organs (kidneys, liver, lung, heart, pancreas, and intestines) as foreign and will attack them. This is called ‘rejection.’ To prevent this response, certain medications are given to the organ recipient. A side effect of these medications is that the body cannot fight off infection as easily as a healthy person.

In contrast, most types of transplanted tissues (i.e., bone, tendons, heart valves and cornea) are not recognized as foreign because they do not have an internal vascular system, like organs do.  Therefore, immune cells and antibodies that travel through blood do not attack the tissue and medications to suppress the immune system are not needed.

How do hospitals get organs and tissues?

Hospitals are required to have written agreements with organizations that coordinate organ and tissue donation and recovery.   There are 58 organ procurement organizations (OPOs) and a larger number of tissue recovery and eye recovery banks that work with hospitals in the United States for this purpose.

What are screening and testing requirements for organ and tissue donation?

Organ and tissue recovery organizations are required to obtain a medical  and social history of deceased donors by asking their next-of-kin, and sometimes other persons who knew the potential donor, questions about:   1) behaviors that may have exposed the potential donor to certain diseases and 2) the potential donor’s past medical history.  This questionnaire serves as one of several resources to assess the donor’s risk for having a disease.

Hospitals are required to evaluate living potential kidney donors for the presence of behaviors or medical history that may increase the risk of infection in the donor. 

OPOs, tissue banks, and eye banks( and a small number of hospitals that perform  organ recovery from kidney donors) are also required to perform certain tests to see if the potential donor may have infections, such as HIV (human immunodeficiency virus) hepatitis B (HBV) or C (HCV) virus, syphilis, and cytomegalovirus (CMV).  These test results are provided to the healthcare facility where transplantation of the organ or tissue will occur. 

What are the reporting requirements for organs and tissues with suspected infections?

Organ Procurement and Transplantation Network (OPTN) policy requires OPOs to report suspected donor-derived disease transmissions to the United Network for Organ Sharing (UNOS) Patient Safety System and to notify all transplant centers that received organs from the same donor.  Additionally, OPOs must contact tissue banks and eye banks that recovered tissues from that same donor.   

Tissue and eye banks are required to investigate suspected communicable disease transmissions related to tissue.  If the recipient infection seems likely to have been caused by the transplanted tissue and meets other criteria (i.e., fatal, life-threatening, permanent damage to body, or requires medical or surgical intervention), the tissue or eye bank that released the tissue must submit findings to the FDA through its MedWatch surveillance system.  Healthcare facilities that perform these transplants are encouraged to report suspected transmissions to the tissue supplier and through the MedWatch system. Reporting is voluntary.

Organ and tissue recovery organizations and living donor recovery hospitals are also required to notify local or state public health authorities when a donor is confirmed to have a an infection that is considered a notifiable infectious disease. Each state maintains a list of notifiable diseases, which can be found on their state health department’s website.

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