DHHS: Screening All Donors for West Nile Virus Still "Impractical"

While all blood donations in the U.S. are now subjected to a test that can detect the West Nile Virus even from donors with no symptoms, the U.S. Department of Health and Human Services says this type of screening is still largely "impractical" for use in decision-making about potential organ donors.

Since the fall of 2002, when health officials first determined that West Nile Virus could be transmitted through an organ transplant as well as through blood transfusion, organ procurement organizations have been concerned with how to prevent inadvertent transmission of the disease from cadaver donors.

Fewer than one percent of individuals infected with West Nile Virus develop severe disease such as encephalitis or meningitis, but because transplant recipients are immunosuppressed, the consequences have been more severe for the small number who have contracted the disease.

While a screening test is widely available for use on potential donors with symptoms suggestive of West Nile Virus, the U.S. Department of Health and Human Services (DHHS) says the screening test for asymptomatic individuals -- used for all blood donations since Summer 2003 -- remains "impractical" for general use in deciding whether to use organs from a cadaver donor.

Only a limited number of testing sites perform the more sophisticated test, and while it may only take four to six hours to perform the test, factoring in transportation time, it often is 24 hours or more before the results are reported back.

"For deceased donors, it is likely that some or all of the organs will have been transplanted prior to availability of the screening test results," DHHS said in new guidance to transplant centers and organ procurement organizations.

"Given the practical limitations of using these screening tests and given that they are still investigational, [DHHS] does not maintain that screening of all organ donors with [this more sophisticated test] should be required at this time," the guidance says.

But it says that if this test is performed on a potential donor, a positive finding of West Nile Virus reported after the organs have been transplanted "has some value for counseling and monitoring the recipients," and potentially for administering a new drug that currently is undergoing clinical trials.

Other Sources: Department of Health and Human Services, UNOS