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Doctors confident over organ donation meningitis risk Doctors confident over organ donation meningitis risk
(about 3 hours later)
A surgeon told an inquest into the deaths of two transplant patients that doctors were confident the donor's meningitis would not be transmitted.A surgeon told an inquest into the deaths of two transplant patients that doctors were confident the donor's meningitis would not be transmitted.
Robert Stuart, 67, from Cardiff, and Darren Hughes, 42, of Bridgend, died after being given kidneys infected with meningitis-causing parasitic worms.Robert Stuart, 67, from Cardiff, and Darren Hughes, 42, of Bridgend, died after being given kidneys infected with meningitis-causing parasitic worms.
Doctors knew the donor had died from meningitis before accepting the organs.Doctors knew the donor had died from meningitis before accepting the organs.
The consultant said, with hindsight, he would like specialist advice to be sought in difficult cases.The consultant said, with hindsight, he would like specialist advice to be sought in difficult cases.
The transplants took place at Cardiff's University Hospital of Wales last year.The transplants took place at Cardiff's University Hospital of Wales last year.
Argiris Asderakis, consultant transplant surgeon at the University Hospital of Wales, told Cardiff Coroner's Court that the 39-year-old donor, who was an alcoholic, had undergone a five-day treatment of antibiotics prior to his death.Argiris Asderakis, consultant transplant surgeon at the University Hospital of Wales, told Cardiff Coroner's Court that the 39-year-old donor, who was an alcoholic, had undergone a five-day treatment of antibiotics prior to his death.
He said: "It was most likely it [the cause of the meningitis] would be covered by the treatment so transmission would not take place."He said: "It was most likely it [the cause of the meningitis] would be covered by the treatment so transmission would not take place."
The inquest heard he had made a decision on the suitability of the organ based on the donor's medical history and information provided by his partner to NHS Blood and Transplant.The inquest heard he had made a decision on the suitability of the organ based on the donor's medical history and information provided by his partner to NHS Blood and Transplant.
He told Cardiff Coroner's Court: "In hindsight, in cases of great difficulty, we should try to find the most expert advice on the night."He told Cardiff Coroner's Court: "In hindsight, in cases of great difficulty, we should try to find the most expert advice on the night."
Mr Asderakis spoke with Dawn Chapman, a specialist transplant nurse, and said he felt confident making an informed decision that the transplants could go ahead.Mr Asderakis spoke with Dawn Chapman, a specialist transplant nurse, and said he felt confident making an informed decision that the transplants could go ahead.
Mr Asderakis told the inquest that even though the kidneys showed signs of dysfunction, this was not uncommon and once transplanted, he would expect the organ to recover and perform normally.Mr Asderakis told the inquest that even though the kidneys showed signs of dysfunction, this was not uncommon and once transplanted, he would expect the organ to recover and perform normally.
The inquest heard that Mr Hughes was not eligible to receive 90% of organs available as he had anti-bodies in his blood which ruled out nine out of 10 potential donors in the UK.The inquest heard that Mr Hughes was not eligible to receive 90% of organs available as he had anti-bodies in his blood which ruled out nine out of 10 potential donors in the UK.
He was waiting for his third transplant and Mr Asderakis said studies show 12% of people waiting for their second or third transplant died within three to five years.He was waiting for his third transplant and Mr Asderakis said studies show 12% of people waiting for their second or third transplant died within three to five years.
Mr Stuart was prioritised for a transplant because of his age.Mr Stuart was prioritised for a transplant because of his age.
Earlier, the court heard organs from a person with meningitis could still be offered for transplant.Earlier, the court heard organs from a person with meningitis could still be offered for transplant.
Anthony Clarkson from NHS Blood and Transplant said organ donors' families are asked about their health and lifestyle history.Anthony Clarkson from NHS Blood and Transplant said organ donors' families are asked about their health and lifestyle history.
He said organs from a person who died from meningitis with an unknown cause would be offered for transplant.He said organs from a person who died from meningitis with an unknown cause would be offered for transplant.
Halicephalobus parasiteHalicephalobus parasite
'Opinion''Opinion'
When asked by assistant coroner Christoper Woolley if organs from a patient with meningitis with a known cause are still offered for transplant, he said: "Not that I'm aware of."
The partner of the kidney donor had been interviewed when he died, and his liver, heart and lungs were all declined for donation due to his medical history.The partner of the kidney donor had been interviewed when he died, and his liver, heart and lungs were all declined for donation due to his medical history.
The inquest was told the donor had a "significant alcohol history" with previous hospital admissions for jaundice.The inquest was told the donor had a "significant alcohol history" with previous hospital admissions for jaundice.
Mr Clarkson said the team at Cardiff were aware that the donor's kidneys had been rejected by five other centres before being offered to them.Mr Clarkson said the team at Cardiff were aware that the donor's kidneys had been rejected by five other centres before being offered to them.
He said a hospital's decision whether or not to accept an organ is "made on the facts available to them, not on other people's decision to accept or decline".He said a hospital's decision whether or not to accept an organ is "made on the facts available to them, not on other people's decision to accept or decline".
The inquest heard there were "a range of reasons" other transplant centres declined the kidneys, including poor function and the cause of death.The inquest heard there were "a range of reasons" other transplant centres declined the kidneys, including poor function and the cause of death.
The central transplant team was not able to contact the donor's GP as it was the early hours on a weekend, but he said this in itself was not a reason not to offer an organ for transplant.The central transplant team was not able to contact the donor's GP as it was the early hours on a weekend, but he said this in itself was not a reason not to offer an organ for transplant.
The fact that other hospitals rejected the organs was "no more than evidence of another surgeon's opinion".The fact that other hospitals rejected the organs was "no more than evidence of another surgeon's opinion".
On Tuesday, the court heard post-mortem examinations revealed both men had the deadly parasitic worm halicephalobus in their bodies after their transplants.On Tuesday, the court heard post-mortem examinations revealed both men had the deadly parasitic worm halicephalobus in their bodies after their transplants.
Pathologist Fouad Alchami said the primary cause of death for both Mr Hughes and Mr Stuart was meningoencephalitis - a form of meningitis - caused by the presence of the worms.Pathologist Fouad Alchami said the primary cause of death for both Mr Hughes and Mr Stuart was meningoencephalitis - a form of meningitis - caused by the presence of the worms.