Broadcaster Derryn Hinch revealed on 60 Minutes last night that moments before his liver transplant surgery went ahead last year, he was told by doctors that the new liver may be infected with HIV or hepatitis as the donor had been a long-term drug user. As Hinch and his surgeon Bob Jones explained on the program:
DERRYN: I didn’t know it but that night, behind the scenes there were all these top-level meetings going on with Bob Jones. I mean, I guess that he was thinking to himself, “well, I don’t want to be the guy that gives Hinch AIDS.”
BOB: In fact we told him just very straight we said we have a young donor who is otherwise a perfect donor, but the trade-off is there is going to be an unknown risk of infection and we’re not going to know about that risk of infection to you for at least three months after the transplant. So the worst case scenario is you sail through the transplant and three months later we say that “you’ve caught HIV, we’ve transmitted it from the donor.”
… DERRYN: Chanel [Hinch’s wife] said, “So what do you think? What are you going to do?” and we talked about it and I said, “darling, I’ve been a gambler all my life — let’s do it.”
Do many patients get offered risky organs or just the annoying ones? Crikey asked the experts.
Who can donate their organs?
Donate Life, the national network of The Organ and Tissue Authority, explains the basics:
“The governing factors are where and how a donor dies and the condition of their organs and tissue. You can still be a donor even if you drink or smoke, are overweight or have a chronic condition. There’s every chance that some of your organs and tissues will be suitable for donation. Only some medical conditions may prevent you from being a donor, such as transmissible diseases like HIV.”
Can anyone receive an infected organ or just Derryn Hinch?
Jonathon Fawcett, from the Transplantation Society of Australia and New Zealand, told Crikey about the allocation system that regulates donor organs. He explained that candidates who have only days or weeks to live fall into the “urgent” category. Only these candidates can be offered potential “risk” organs coming from a donor that have less than satisfactory medical histories, such as known substance use.
Has this happened before?
Fawcett acknowledged that Hinch’s case is uncommon but trade-offs aren’t unheard of.
He told Crikey that “in a perfect world, all donors have a satisfactory history and everyone would receive excellent organs. Unfortunately, the reality is there are a shortage of donors. We don’t like it [trade-offs], but it is a pragmatic approach … we give them a chance that they might not otherwise have.”
Fawcett explained that in the very first stages of assessment, patients and their families are made aware of their chances of organ transplant. He assured Crikey that patients are very conscious of the different stages of the transplant process and the potential options once the “urgent” stage is reached.
Is it ethical to offer desperate patients a risky organ?
Fawcett believes it is ethical because patients are offered a chance that they otherwise would not have. “It is all discussed,” he told Crikey. “They are counselled … they understand and give willing consent.”
What are the chances of receiving an organ infected with a disease?
Fawcett acknowledged that you don’t always know if a donor’s organs contain disease such as HIV. He explains that if a donor is tested and is positive to HIV, their organs are not used.
“We have the most sophisticated techniques but there is what we call a window period, where HIV could appear later,” explained Fawcett.
He explained that all donors undergo rigorous medical testing before they are confirmed to be a suitable donor.