Teen's organs prove deadly for recipients

Alex Koehne had a love for life and always wanted to help people.

So when his parents were told that their 15-year-old son was dying of bacterial meningitis, the couple did not hesitate in donating his organs to desperately ill transplant recipients.

"I immediately said, `Let's do it'," Jim Koehne recalled. "We both thought it was a great idea. This is who Alex was."

A year later, their dream that Alex's spirit might somehow live on has become a nightmare.

It turned out that Alex did not die of bacterial meningitis, but rather a rare form of lymphoma that was not found until his autopsy, and apparently spread to the organ recipients.

The suburban New York couple was told that two of the recipients had died and two others had the donor kidneys removed and were being treated for cancer.

The revelation has led two hospitals to revise transplant procedures, although the state Health Department found that no one was to blame. Experts said getting cancer from an organ donor was extremely rare: only 64 cases have been identified in a national study of 230,000 cases, according to the United Network for Organ Sharing.

"A 15-year-old boy's organs are a gift from the Almighty," said transplant surgeon Lewis Teperman, noting that most organ donors were much older than Alex. "Usually the organs from a 15-year-old are perfect. In this case, they weren't."

Dr Teperman is the director of transplantation at New York University Medical Centre, where two of the transplants were done, and lead author of a report on the case.

In March of last year, Alex was taken to Stony Brook University Hospital on Long Island after treatment at another hospital for nausea, vomiting, severe back and neck pain, seizures and double vision. Doctors told his parents they suspected he had bacterial meningitis - an infection of the fluid surrounding the spinal cord and brain - although tests did not reveal what bacteria caused it.

He was treated with antibiotics but died on March 30 last year.

The Koehnes requested an autopsy. They were told that Alex had actually died from non-Hodgkin's lymphoma, but in a rare form of the blood cancer that affects fewer than 1,500 people in the US annually.

"Our jaws dropped," Mr Koehne recalled. "We walked out of there crying."

Mr Koehne and his wife, Lisa, later learned that a 52-year-old man died of the same rare lymphoma about four months after receiving Alex's liver.

The couple said they were also told a 36-year-old woman who received Alex's pancreas also developed lymphoma and died.

Two patients who received the kidneys were undergoing cancer treatment and were faring well, according to a report in the American Journal of Transplantation.

All four recipients were notified immediately of the autopsy results and received chemotherapy, the report said. None has been publicly identified.

The report's authors noted a diagnosis of bacterial meningitis does not preclude donating organs, because the recipients can be given antibiotics to prevent infection, but they concluded "a more thorough evaluation of the donor" should be done when there is any doubt.

SCMP. Apr 09, 2008