Vincent Liew's kidney transplant was going to give him a new lease on life, or so he and his wife, Kimberly, thought.
What Liew, 37, and his doctors didn't know then was that his new kidney had come with an undiagnosed cancer from its original owner, one that would cause him to die seven months later of uterine cancer.
The New York City man's autopsy revealed widespread tumors in his lungs, bladder, kidneys and prostate, all consistent with the kind of uterine cancer cells found post-mortem in the donor.
Kimberly Liew is now suing the doctors at the NYU Medical Center who performed the transplant, claiming that they didn't properly screen the organ, failed to recognize and treat Liew's cancer, and withheld information concerning the donor's cancer from the couple, according to court documents.
"They made up a lot of excuses," Liew told the New York Daily News. "They told us the kidney is not adapting to his body. They didn't tell me he had cancer."
When Liew was called in for a transplant in February of 2002, he was given a second chance at health that only a fraction of those on the list will ever get.
Although the organ had been cleared for use by the New York Organ Donor Network before the transplant, results from the donor's autopsy later revealed that she suffered from an undiagnosed uterine cancer that had spread to the right ovary and lungs, court papers say.
The discovery was made days after the transplant but, Kimberly Liew claimed, the information was not shared with her or her husband until six months later, when the donor kidney was finally removed by Liew's transplant surgeon, Dr. Thomas Diflo, court papers said.
Neither the NYU doctors nor Liew's attorney, Daniel Buttafuocco, could comment because the judge has issued a gag order on the trial, which began Tuesday in the Queens Supreme Court.
Although it is rare for a donor organ to transmit cancer to a transplant patient, it is not unheard of.
"A patient acquiring a disease from a donor rears its head periodically," said Dr. David Cronin, associate professor of transplant surgery at the Medical College of Wisconsin. "Whenever you take a tissue or an organ or a substance from another human being you're at risk to transmit infectious disease or cancer."
The risk may be small, about 1 percent, according to the United Network for Organ Sharing, but it is unavoidable, Cronin said, because doctors are "limited by the technology we have [to screen donors] and the time constraints."
Although surgeons can have as many as 20 hours for kidney transplants to organize the transplant and screen the donor for eligibility, the window is fewer than 10 hours for livers and fewer than six for hearts.
If cancer in a donor went undiagnosed in life, it can be hard to screen for it after the donor has died.
When the donor organ is removed, the surgeon usually does a survey of the chest and abdominal cavity to look for evidence of cancer or infectious disease, Cronin said, and biopsies anything suspicious. Cancers can also be detected later during an autopsy of the donor, but the transplant has already usually taken place by then.
In some cases, the risk of transferring cancer or infection is a calculated one, one that the patient and his or her doctor knows about going in. Using organs from less-than-ideal donors, known as extended criteria donors (ECDs), has become more common, said Dr. Fredric Gordon, Medical Director of Liver Transplantation at the Lahey Clinic Medical Center in Burlington, Massachusetts.
There just aren't enough organs available in the United States, so transplant programs are taking more risks [with ECDs] rather than let patients die on the list instead," he said.
There are 84,722 patients on the waiting list for a kidney transplant, according to the United Network for Organ Sharing, and more than 33,000 new patients are added each year. In 2009 alone, 4,540 patients died while waiting for a donor kidney.
If the donor is known to have had cancer or to have cancer at the time of death, this "raises a red flag," said United Network for Organ Sharing vice president Charles Alexander, but isn't necessarily a deal-breaker.
"Each type of cancer has its own associated risk," he said. "Certain brain cancers are thought safe for a donor to have, others not, it's a donor-specific determination."
But transparency is key in such situations. The risk needs to be something the patient and his or her doctor decide is worth taking, the Lahey Clinic's Gordon said.
Dr. Scott Johnson, surgical director of kidney transplants at Beth Israel Deaconess Medical Center in Boston, estimated that about 5 percent of donated organs nationwide fall into the high-risk category.
Although only 1 percent of transplant cases will actually result in a disease transmission, Wisconsin's Cronin noted, it doesn't make those rare cases any easier.
Liew's case was not the first of its kind for NYU Medical Center.
Two transplant patients received cancerous organs in 2008 after a donor from another hospital was mistakenly diagnosed with bacterial meningitis. The donor, who had actually died of lymphoma, passed on his cancer to three transplant patients, two of which later developed lymphoma and died.
The medical center tightened its requirements for proof of bacterial meningitis status in donors as a result of the case, but unforeseen transmission, as Cronin noted, is still possible.
At the same time, transplant surgeons say that it's essential to keep the donor pool as wide as reasonably possible because the risks rarely outweigh the slim chance of survival without a transplant.
"We should preserve the option of donation whenever possible," said Dr. Jeffrey Punch, chief of transplant surgery at the University of Michigan. "It's a tragic waste … to bury or burn organs that can save lives."
Gordon agreed, noting that while less-than-perfect donors carry extra risks, it should be up to the surgeon to know what's right and up to patients to decide how much risk they are willing to take on. "I wouldn't want a regulation stopping me from using an organ because it's not [100 percent] risk-free," he said.
The whole situation is tied up in different risks, Cronin said. "Once you go on dialysis, you're more likely to die than to get a transplant in the first place," he said. "Then you get into the risks of the organ itself.
"If I was to need a heart, liver, or kidney and you told me I had a 10 percent chance of getting a deadly disease, I'd say fine because without the transplant, my chances are even worse."
ABC News' Susan Donaldson James contributed on this report.