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World & Nation

Two in China receive kidney transplants, contract rabies and die

Transplant surgery
Surgical instruments are used during a kidney transplant surgery.
(Associated Press)

Two men in China died of rabies after receiving kidney transplants from an infected donor, according to Chinese medical researchers. 

Last summer, a 55-year-old man from Hebei province near Beijing and a 43-year-old man from Liaoning province in the country’s far northeast died after receiving organs from the cadaver of a 6-year-old boy who had suffered from undiagnosed encephalitis, the researchers reported in the most recent issue of the journal Emerging Infectious Diseases.

Rabies transmission through organ transplantation has also occurred in the United States, but it is extremely rare. 

“I think, personally, this case just highlighted some of the fractures in the system,” said Dr. Peter Chin-Hong, an infectious disease specialist at the UC San Francisco School of Medicine.

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“When I looked at the report, my first reaction was, ‘This is really rare, and also kind of unfortunate,’” he said. “My second was, ‘Well, would we actually be comfortable with transplanting, in this particular case, if it happened here in the U.S.?’ And I’d probably be nervous about that particular donor.

I think, personally, this case just highlighted some of the fractures in the system.
Dr. Peter Chin-Hong, infectious disease specialist at UC San Francisco School of Medicine

“My third was, ‘Wow, if I was gonna take organs from this donor, and I was worried about it, I’d probably give them to somebody who would immediately die without these organs,’” he said, adding that with kidneys, “there’s rarely a need for immediate transplantation.”

The boy, who lived in the impoverished, mostly rural southwestern Guangxi province, contracted a fever on May 13, 2015, according to the article. Two days later, with the fever still raging, he “showed additional symptoms of extreme irritability, screaming, and slurred speech.” By Day 3, he was foaming at the mouth. 

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The boy was moved to another hospital, where he entered a coma. He died 10 days later. 

The body tested negative for HIV, hepatitis B and syphilis, so doctors determined that his organs were adequately safe for transplantation, and collected his kidneys and corneas. No autopsy was performed.

The man from Hebei received a kidney on May 27, 2015, in Beijing. That July, a fever and “mild abdominal distention” quickly developed into something worse — he began to lose his hearing, and speak incoherently. He had difficulty swallowing. Doctors suspected rabies, and later, confirmed the diagnosis. He died Aug. 23.

The second recipient, from Liaoning, showed many of the same symptoms. He died on Aug. 17. Realizing that the boy may have had rabies, medical authorities alerted two people in southern China who had received the boy’s corneas. Neither had developed symptoms of rabies, but both were treated for the virus as a precaution.

“Rabies in the two kidney transplant recipients probably resulted from rabies virus transmitted from the common organ donor,” concluded the researchers, who are affiliated with the Fudan University School of Public Health, the Chinese Center for Disease Control and Prevention, and other prominent Chinese institutions.

They could not definitively confirm the disease’s source, as the donor was cremated after his organs were collected.

China’s organ transplantation system is highly controversial. Human rights groups and activists from the banned spiritual group Falun Gong have accused authorities of killing political prisoners to sell their organs. A documentary released in April — “Human Harvest: China’s Organ Trafficking” — claims that the country’s illegal organ trade is worth $1 billion a year.

Authorities pledged to stop harvesting executed prisoners’ organs in December 2014, after admitting to the practice a few years earlier. 

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The country has one of the world’s lowest organ donation rates — the U.S. rate is more than 40 times higher.

“I think it’s hard to know what’s going on in China, with medicine and health,” Chin-Hong said. “The country is so big, and there are so many layers, you can never penetrate those deeper areas. People are motivated by unknown causes. What’s the narrative of the families in this organ transplantation case? This kid, in this rural area? You can only wonder.”

jonathan.kaiman@latimes.com

Twitter: @JRKaiman

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