Anthony Taylor had hoped his kidney and liver transplant would save his life. Instead, the new organs gave him skin cancer, which caused his death.

A kidney from the same donor also gave another recipient terminal cancer. Now both families are suing the Indiana Organ Procurement Organization because they believe not enough was done to make sure the donor organs were healthy.

"The question is how could this happen, obviously, and the answer lies in what was actually done in the testing and evaluation to qualify this donor to be an acceptable organ donor," said Frederick Hovde, attorney for Taylor, who died from cancer about a year after the transplant.

Susan Cline, a lawyer representing the organ procurement organization, which helps arrange transplants in Indiana, defended the group.

"Based upon what we can tell from our files, the procurement and screening were done in compliance with all state and federal regulations," said Cline, an attorney with Locke Reynolds.

Transmission of disease from donor to recipient occurs less than 1 percent of the time, said Dr. Michael Nalesnik, vice chairman of the disease transmission advisory committee of the United Network for Organ Sharing. The network administers the country's organ procurement and transplantation network.

"Every case like this is tragic, and you come back and look at it and say, 'Could this have been done or could that have been done, or what's the lesson, how can we avoid this?' " said Nalesnik, a professor of pathology at the University of Pittsburgh Medical Center.

There are more than 28,000 transplants annually nationwide; about 570 transplants are performed in Indiana each year.

Experts say there's no way to ensure that every donor organ is free of disease. Many diseases are nondetectable in the early stages, no matter how extensive the testing.

The federally funded nonprofit United Network for Organ Sharing has guidelines to help ensure donor organs are as healthy as possible. The guidelines dictate medical tests and examinations that should be performed before an organ is accepted for transplants.

Still, the guidelines leave wide discretion to the more than 50 organ procurement agencies that assess organs. Transplant surgeons also have leeway to reject organs, a decision they sometimes make with limited information about a potential donor.

All these assessments must be done against the clock in order to ensure that organs reach their recipients as soon as possible, because organs perish quickly.

The possibility of Taylor receiving a diseased organ never occurred to him and his family, said Denise Taylor, his wife of 22 years.

Taylor, who loved to bowl and worked in a foundry, had struggled with chronic kidney disease for years. The transplant promised to end that.

So the family listened carefully when the doctors told them what Taylor needed to do to be eligible for a transplant. They changed his diet and went for regular check-ups.

"We did everything we were told we were supposed to do," Denise Taylor said in a phone interview from her South Bend home.

Two months after Anthony Taylor started dialysis, he was offered a transplant.

"If your husband has a transplant, you're thinking your life is going to start again. . . . Once he got his transplant, I was thinking this was going to be great," Taylor said. "And then your life is snatched away from you."

In the first months after his operation at Indiana University Hospital in October 2006, Taylor adjusted well. By March, he felt healthy enough for a family trip to California.

Just before the family left, they learned that routine tests had revealed abnormalities in Taylor's blood. When the family returned, doctors discovered that cancer cells, which had originated with the female donor, now riddled his new liver.

Doctors radiated his liver in an effort to halt the cancer. But the cancer soon spread. On July 27, 2007, Anthony Taylor died at the age of 45.

The following week, James Fell, who received a kidney from the same donor as Taylor, learned that he, too, had metastatic melanoma, skin cancer. On Sept. 30, 2007, the Fort Wayne man died of cancer.

Tracy Stratman, Fell's daughter, also is suing the organ procurement organization for failing to make sure the organ was disease-free. She declined to comment for this story, but her lawyer David Farnbauch said he thinks those involved with choosing the organ ignored signs the donor could have been unsuitable.

"I don't think it would be reasonable to expect in every donor situation that they would be able to screen it and investigate in such a way that you could rule out the possibility that this thing would never happen," he said.

"But I think there are situations -- and we believe that this is one of them -- where there may have been some telltale signs of melanoma that were not screened and investigated."

The two Indiana cases are not the first involving transplant recipients contracting disease from their new organs.

In 1995, a North Carolina man sued a procurement organization after receiving a diseased kidney from a man who died of lung cancer. The case settled out of court.

Last year, four patients in Chicago learned that they had received hepatitis and HIV along with their new organs.

Earlier this year in Boston, one person died and another was in critical condition after receiving kidneys from a donor infected with hard-to-detect lymphocytic choriomeningitis virus, the same disease that killed three transplant patients in Massachusetts in 2005.

With more than 100,000 people waiting for organs in the U.S., demand is high. Organ procurement organizations work against time to make sure organs are safe, Nalesnik said.

First, there's a detailed history of the donor. Doctors examine the body, looking for lesions and surgical scars.

In some cases -- if a donor dies of a brain hemorrhage, which can signal the presence of cancer -- doctors may recommend scanning the body to determine the cause of the hemorrhage.

Finally, the surgeons may manually check the organs, looking for any bumps, Nalesnik said. If they feel something suspicious, they may request a biopsy.

Even the best efforts can fail to detect early disease, he said.

"Life isn't perfect, and sometimes things can get by," Nalesnik said.

Even if an organ has a disease, the disease is not always contracted by the transplant recipient.

A 2004 study by University of Cincinnati doctors looked at the outcomes of 13 donors with melanoma who gave organs to 38 recipients. The study used data from the university's Israel Penn International Transplant Tumor Registry, a voluntary registry of more than 19,000 patients who have received transplants since 1967.

Of the 38 recipients, about 76 percent, or 29 people, developed melanoma, and 19 died. All but one had metastatic disease, according to Dr. E. Steve Woodle, director of the registry.

The organ-sharing network asks doctors to report all suspected cases of disease transmission between organ donor and recipient. The committee that Nalesnik helps chair is reviewing current guidelines for screening organs.

Deciding which organs to accept or reject can be a balancing act, experts say.

"You have patients in desperate need of organs, and sometimes there's no way to be 100 percent safe. And if we were 100 percent safe in everybody, we would be letting a lot of useful organs go by the wayside," said Woodle, chief of transplant surgery at the University of Cincinnati.

Different medical centers may employ different criteria for organs, said Art Caplan, chairman of the department of medical ethics at the University of Pennsylvania, who has researched transplants for the past 25 years.

"An organ used in Indianapolis might not be used in Illinois," he said. "There isn't a national standard about who should be eligible to be a donor."

For instance, officials in one state might balk at using organs from a person killed in a car accident, afraid they know too little about the donor. Doctors elsewhere might accept the organ, Caplan said.

Earlier this year, Caplan and some colleagues published an article arguing for greater consistency and disclosure about the potential risk associated with marginal organs.

Today, Denise Taylor said she's not sure whether her family's experience has changed how she thinks about organ donation.

"That's really a hard question to answer," she said. "We did what we had to do that was necessary to prolong my husband's life, which was to get a transplant. I don't know now if I would take a chance on doing it."