While serious infections can be transmitted from donated organs, the risk of passing Ebola virus disease from an organ donor to a recipient is extremely small. In a new editorial published in the American Journal of Transplantation, experts explain how simple assessments of donors can help ensure that the organ supply is safe, while having little impact on the donor pool.
Despite screening all organ donors for infection, on rare occasions an organ donor will transmit an unexpected infection to a recipient. Because cases of Ebola virus disease have occurred in the United States recently, clinicians want to make sure that appropriate steps are taken to reduce the already low risk that Ebola virus could be unknowingly transmitted from donor to recipient. Experts note that simple screening questions, many of which are already asked, can be used to assess if donors have risk for harboring Ebola virus disease. Also, investing in new laboratory-based testing is likely not practical or effective. "Thousands of people die in the United States each year waiting for an organ transplant, and we think it is very important not to overreact to the very low risk that a potential donor might have the Ebola virus, and, as a consequence, unnecessarily discard potentially life-saving organs," said lead author Daniel Kaul, MD, who is the director of the transplant infectious disease division at the University of Michigan in Ann Arbor and the chair of the United Network for Organ Sharing's Disease Transmission Advisory Committee.
Dr. Kaul and his colleagues suggest that individuals who travelled in the past three weeks to the countries in Africa where Ebola virus is active, as well as health care workers and others in the United States who were recently exposed to someone infected with Ebola virus, should not donate organs. While it is difficult to know how long a person should be kept from donating after exposure to the Ebola virus, they feel that a 21-day exclusion period is reasonable. "We think that after the 21-day period, doctors taking care of the patients involved could consider using those organs after talking with the potential recipients if that organ might be the recipient's best chance to survive," said Dr. Kaul.