I am a hepatitis B chronic carrier. I know that I cannot be a blood donor. Can I be an organ donor?

L.U.

Your question brings up some important points about donating blood and organs. As you may know, hepatitis B, as well as other viruses such as hepatitis C and HIV, are easily transmitted through blood. Blood transfusion was once a major cause of the spread of these infections. Today, because of routine testing of blood and blood products, transmission of these infections through transfusion is quite rare.

The screening tests for organ donors are virtually the same as those for blood donors. Preventing infections transmitted by organ donation has proved to be a little more difficult, however. Most important is the time factor in organ transfusion. Organs last only a short time after the donor dies, so all tests must be performed rapidly. In addition, some infections in an organ cannot be detected by blood tests.

Despite these problems, serious infections transmitted by organs are rare. There are case reports describing the transmission of HIV, hepatitis B and C, rabies, toxoplasmosis, cytomegalovirus and a fatal brain illness called Creutzfeldt-Jakob disease. (Probably the most common infection transmitted by organs is cytomegalovirus, or CMV. This is a very common infection in transplant recipients. It can occur even if the transplanted organ tests negative -- because the virus can reactivate when the transplant recipient receives drugs to prevent rejection of the organ.)

So while we are in great need of organ donors, we are also in need of safe organ donors. For this reason, people with chronic hepatitis B or C should probably not list themselves as organ donors.