CDC issues new guidelines to prevent HIV transmission during transplants.

The risk of getting the human immunodeficiency virus (HIV) from transplanted tissue is low, but it has happened. For example, in 1986, major organs from a gunshot victim who had tested seronegative transmitted the virus to several recipients. It is assumed that he had been infected shortly before his death and had not yet developed the antibodies used to detect the virus.

The incident sent shock waves through the public health community, and in 1991 the federal Public health Service set up a working group to assess the threat. Last May the Centers for Disease Control and Prevention (CDC) in Atlanta issued new prevention guidelines. (Guidelines for Preventing Transmission of Human Immunodeficiency Virus Through Transplantation of Human Tissue and Organs, Centers for Disease Control and Prevention, Morbidity and Mortality Wkly. Report, May 20, 1994.)

The report considers all bodily vehicles for the virus--not just transplanted organs and tissues but also donated semen and breast milk. (Guidenlines for donated blood are considered sufficient.) The report addresses donor screening, testing, and exclusionary criteria; quarantine of tissue from living donors; preliminary disinfection of transplant material; recall of stored material that came from infected donors; and detecting, reporting, and tracking potentially infected tissues and recipients.

The report recommends that hospitals and organ banks screen all living donors, giving them both physical tests and life-style evaluations as if they were going to give blood. Blood from dead ("cadaveric") donors should be tested and part of it preserved for future reference, and close family members of the donor should be questioned about lifestyle factors that might have posed a risk. Other recommendations include the following:

* Prospective organ donors and next of kin or life partners of brain-dead or deceased donors should be educated and screened as to modes of transmission and risk factors for HIV infection. Potential donors' medical records should be obtained and examined.

* Living prospective donors should be physically examined and tested. Where possible, a waiting period for the latent virus to develop should be observed. Milk donors should be screened like blood donors and the milk pasteurized.

* Recipients of solid organs should be tested for HIV right before the operation and three and six months after.

* If evidence suggests a donor was infected, the tissue bank should locate all recipients and warn them. The remaining infected tissues should be retrieved and used only for research or destroyed.

Single copies of the report can be obtained by calling the National AIDS Clearinghouse at [phone].