ShareThisBob Warzel had what he thought was a successful kidney transplant a year ago at University of North Carolina Hospitals. Two weeks later, he learned that the gift contained a hidden surprise -- cancer.
Warzel, 66, who had the donated organ removed, has not developed the lymphoma evident in the kidney. But he and his wife, Patricia, have spent the last year struggling to learn how the incident occurred and working to make sure it never happens again.
The diseased organ came from Duke University Medical Center, reportedly recovered from a young man who died in a traffic accident. But the cancer wasn't discovered until after his kidneys were transplanted -- one in Warzel and the other in an unidentified patient at Duke.
The Duke patient's body rejected the organ, and only then did tests reveal the cancer.
Beyond those basic facts, however, the Warzels have met stony silence as they have sought information about the donor, the eligibility screenings by the organ procurement agency or the suitability tests done at Duke.
"Everyone just wants us to go away," Patricia "Pat" Warzel said.
Federal records indicate that between 1994 and March 2009, 39 deceased kidney donors nationwide had a history of lymphoma or leukemia. More than 16,000 kidney transplants are done a year in the United States, according to the U.S. Department of Health and Human Services.
A similar case came to light in 2008, when a 15-year-old New York boy died with undetected lymphoma. His liver, pancreas and kidneys went to four recipients, and two later died of the cancer.
Potential donors -- often traffic or trauma victims -- are identified by their driver's licenses, which carry a red heart symbol indicating their wish to give their organs for transplant. But in a race against time to preserve fragile organs that could save lives, the types of screening tests conducted are designed to catch the most likely and dangerous possibilities.
"We can't go and biopsy every single part of the body," said Dr. Deb Sudan, chief of abdominal transplant surgery at Duke. "If there's a suspicion, it would be looked at. But there would have to be something that raises a suspicion to do that."
Dr. John P. Leonard, an oncology professor and lymphoma expert at Weill Cornell Medical College in New York, said the kind of cancer Warzel's organ donor had, a slow-growing disease called splenic marginal zone lymphoma, could well have caused no symptoms. Unless there were elevated white blood cell counts associated with advanced disease, he said, blood tests during screening would register as normal.
"These are chronic lymphomas, where patients often live for decades, sometimes without treatment, though in many cases they ultimately require treatment and sometimes can be life-threatening," Leonard wrote by e-mail.
Citing a federal privacy law -- the Health Insurance Portability and Accountability Act, or HIPAA -- officials at Duke and Carolina Donor Services said that to protect the privacy of the deceased donor, they cannot speak about the specifics of the case.
In general, officials said, measures are taken to rule out donors who have diseases, including recent histories of cancer.
Bob Warzel's two kidneys retain limited function -- native kidneys are not removed when donated organs are implanted -- and he worries he'll eventually need dialysis. He now tends his wife, who was diagnosed with breast cancer last fall, and hopes one day to receive the lifesaving organ he needs.
"We would love to have answers," Pat Warzel said, "so that this doesn't have to happen to someone else."
(E-mail reporter Sarah Avery at sarah.avery(at)newsobserver.com. For other stories, visit www.scrippsnews.com.)
(Distributed by Scripps Howard News Service, www.scrippsnews.com.)
Must credit The News and Observer of Raleigh, N.C.
There is more to this than
There is more to this than just this article. Duke was starting a small bowel program over a year ago, without key personnel, without nursing education, without an ICU plan, without anyone who knew anything about it except the new chief. Any nurse, or anyone, who raised any concerns about the new program, were quickly punished and discredited. I am sure they dont want you to know about that either, or the large turnover in personnel, or any of the other issues that involve patient safety.
Supposedly, doctors more
Supposedly, doctors more cautious in examining an organ donor so that things like this do not happen again.
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