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New York City Department of Health investigators say it happened in 2009 – the first transmission of HIV from a live organ donor in the country since screening for the AIDS virus began more than 25 years ago.

And, they say it happened even though the hospital followed stringent pre-screening guidelines. While Mt. Sinai Medical Center is not where this occurred, NY1 asked the director of its abdominal organ transplant institute what might have gone so wrong.

“We have to recognize about those tests that there are windows. And, by windows, we mean you can be infected yet still test negative until the test converts,” explains Dr. Sandy Florman of Mr. Sinai. “The screening test for HIV is an antibody test and the window is about 10 weeks, so there is a period of 10 weeks from when the individual can be infected but the antibody does not convert and show up as positive on the test.”

The New York State Health Department is now recommending transplant centers do a second round of tests on living donors about a week before surgery with more rapid testing methods. They are also urging donors not to engage in high-risk behaviors prior to transplant.

There are already concerns in the transplant community that anything that puts the safety of organ donation in question is bad for everyone.

“This is life and death and there are people that are going to die because they didn't have the opportunity to get a transplant,” Florman says. “So the responsibility is on the entire transplant community to recognize this is a tragic and unfortunate event, and if there are ways we can make living donation safer and instill confidence in the public, absolutely we are going to do it.”

More than 90,000 people are currently on the waiting list for kidneys nationwide.

The only other known case of HIV transmission from a living kidney donor was Italy. That was in 1989.