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Doctors confident over organ donation meningitis risk Kidney transplant surgeon apologises after patients died
(about 1 hour 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 has apologised after carrying out a transplant which resulted in the deaths of two patients.
Robert Stuart, 67, from Cardiff, and Darren Hughes, 42, of Bridgend, died after being given kidneys infected with meningitis-causing parasitic worms. Argiris Asderakis told Cardiff Coroner's Court he was "terribly sorry" and wished he could "turn the clock back".
Robert Stuart, 67, of 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. Mr Asderakis told the inquest on Wednesday: "I'm terribly sorry for what happened, I wish I could turn the clock back in hindsight, but hindsight is a great thing for us all."
The consultant said he would now 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. Mr Asderakis said the 39-year-old alcoholic donor had undergone a five-day treatment of antibiotics before 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." "It was most likely it [the cause of the meningitis] would be covered by the treatment so transmission would not take place," he said.
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 said his decision was based 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." "In hindsight, in cases of great difficulty, we should try to find the most expert advice on the night," said Mr Asderakis.
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. After speaking to specialist transplant nurse Dawn Chapman, Mr Asderakis was confident 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. He said even though the kidneys showed signs of dysfunction, this was not uncommon. He expected to 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.
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.
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.
He said organs from a person who died from meningitis with an unknown cause would be offered for transplant.
Halicephalobus parasiteHalicephalobus parasite
'Opinion' Mr Asderakis also said a hospital in Leeds, which had refused the kidneys, later said, on the balance of risk, it should have accepted them.
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. "This case highlights that no-one could have predicted the first human-to-human transmission of a bug that no-one knew of before," said Mr Asderakis.
The inquest was told the donor had a "significant alcohol history" with previous hospital admissions for jaundice. The inquest heard Mr Hughes, who died on 17 December, had undergone two previous transplants and was not eligible to receive 90% of organs available because he had anti-bodies in his blood.
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 Stuart was prioritised because of his age.
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 was earlier told organs from a donor with meningitis could still be transplanted to patients.
The inquest heard there were "a range of reasons" other transplant centres declined the kidneys, including poor function and the cause of death. Anthony Clarkson from NHS Blood and Transplant said donor families were asked about their health and lifestyle history.
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 donor in this case had his liver, heart and lungs rejected because of his "significant alcohol history" and previous hospital admissions for jaundice.
The fact that other hospitals rejected the organs was "no more than evidence of another surgeon's opinion". Mr Clarkson said UHW was aware 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 was made on fact "not on other people's decision to accept or decline".
'Another surgeon's opinion'
The fact 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 men was meningoencephalitis - a form of meningitis - caused by the presence of the worms.