A transplant patient contracted AIDS from the kidney of a living donor, in the first documented case of its kind in the United States since screening for HIV began in the mid-1980s.
The donor turned out to have had unprotected gay sex in the 11 weeks between the time he tested negative and the time the surgery took place in 2009.
In a report Thursday on the New York City case, the Centers for Disease Control and Prevention recommended that organ donors have repeat HIV tests a week before surgery.
"The most sensitive test needs to be done as close as possible to the time of transplant," said Dr. Colin Shepard, who oversees tracking of HIV cases for the New York City Health Department.
The CDC also said would-be organ donors should be told to avoid behavior that can increase their chances of infection.
Living organ donors in the United States are routinely tested for infectious diseases such as hepatitis and HIV. But the organization that oversees organ transplants in the United States does not have an explicit policy on when such screening should be done. That's left up to transplant centers.
Because of patient confidentiality, health officials released few details about the donor, recipient, their relationship or the hospital where the transplant took place, except to say that it is in New York.
Neither the donor nor the recipient knew he or she had HIV until about a year after the transplant, according to the CDC report.
The recipient developed AIDS, perhaps because he or she was on drugs that suppress the immune system to prevent organ rejection, while the donor did not, health officials said. Both are receiving HIV treatment. Their conditions were not disclosed in the report.
HIV infections in a donor or recipient may not be discovered until long after a transplant, and even then, patients and their doctors may not make the connection and report it, health officials said.
In an unconfirmed case, an Orlando, Fla., woman filed a lawsuit last year saying she had been infected with HIV through a 2007 kidney transplant from a live donor in Florida.