Organ transplant deaths investigated

By Dr. Ananya Mandal, MDMar 3 2011

Three women died within one week of each other after they received diseased organs in transplant procedures at the Austin and Royal Melbourne hospitals according to an ongoing inquest.

At least one may have reconsidered her decision to receive a kidney transplant if she had known the donor had hepatitis B. The deceased women, Gurpal Sandhu, 64, Carmellina Sirianni, 63, and Karen Wilkinson, 43 allegedly died on arenavirus infection.

This virus is a rare and recently detected rodent disease that has never infected other transplant patients. The donor, Jovo Vranjesevic, 57, died in late 2006 of a cerebral hemorrhage, having returned to Australia for three weeks from Serbia having lost 15 kilograms. His kidneys and liver were donated. It is alleged that he had arenavirus infection and hepatitis B. Ms Wilkinson died on January 1, 2007, after several weeks in hospital. Mrs. Sandhu died on January 3 and Mrs. Sirianni on January 7.

Mr. Vranjesevic’s surgeon Michael Fink told the Coroners Court yesterday that when he harvested Mr Vranjesevic’s kidneys and liver he did not undertake the responsibility to check whether the organs would be used for transplant, but only if they were suitable. He testified that he believed the kidneys “could go either way” with regard to their use in a transplant and was only concerned about their arteries. Dr. Fink said there were antibiotics suitable to reduce the risk of infection from donors with hepatitis B or C, or HIV. He said that there was a five to seven-year waiting list for kidney transplants and that their allocation was not determined until after harvesting.

Next Ms. Wilkinson’s partner, Rae Moran, told the inquest that if Ms Wilkinson had known Mr Vranjesevic had hepatitis B, she might have changed her mind about the procedure.

Coroner Audrey Jamieson is examining the screening process for donors and recipients, informed consent of recipients, whether there was any opportunity to learn earlier of the deteriorating condition of the three women before they died and if that would have changed the outcomes, and the capacity to now screen for arenavirus. The virus was also detected in the United States in transplant-related cases in 2003 and 2005.

In opening remarks, she told the court that Victorians needed to have confidence in the state’s donor transplant system but emphasized that she was not aware of any deaths from the same virus since those that the inquest is examining. “We hope that there’s things we might learn and improve from these deaths,” Ms Jamieson said.

The inquest continues.