HIV-positive organs transplanted in U.S.
If new approach works, hope is it could free up space on the waiting list
Surgeons in Baltimore for the first time have transplanted organs between an HIV-positive donor and HIV-positive recipients. It's a long-awaited new option for patients with the AIDS virus whose kidneys or livers also are failing.
Johns Hopkins University announced Wednesday that both recipients are recovering well after one received a kidney and the other a liver from a deceased donor — organs that ordinarily would have been thrown away because of the HIV infection.
Doctors in South Africa have reported successfully transplanting HIV-positive kidneys but Hopkins said the HIV-positive liver transplant is the first worldwide.
"This could mean a new chance at life," said Dr. Dorry Segev, a Hopkins transplant specialist who pushed for legislation lifting a 25-year U.S. ban on the approach and estimates that hundreds of HIV-positive patients may benefit.
For patients who don't already have the AIDS virus, nothing changes — they wouldn't be offered HIV-positive organs.
Instead, the surgeries, performed earlier this month, are part of research to determine if HIV-positive transplants really can help HIV-positive recipients.
The reason: Modern anti-AIDS medications have turned HIV from a quick killer into a chronic disease — meaning patients may live long enough to suffer organ failure, either because of their HIV or for some other reason. In the U.S., HIV-positive patients already are eligible to receive transplants from HIV-negative donors just like anyone else on the waiting list.
That list is long — for kidneys, more than 100,000 people are in line — and thousands die waiting each year. There's no count of how many of those waiting have HIV, but Segev said it increases the risk of death while waiting.
If the new approach works, one hope is that it could free up space on the waiting list as HIV-positive patients take advantage of organs available only to them. Segev estimated that 300 to 500 would-be donors who are HIV-positive die each year, potentially enough kidneys and livers for 1,000 additional transplants.
"It increases the pool of potential organ donors and allows more people to be transplanted. That's the advantage of this whole thing, but it is a research project so we are going to monitor it very carefully," said Dr. David Klassen of the United Network for Organ Sharing, which oversees the nation's transplant system.
Hopkins is the first transplant center given permission to study what's being called HIV-positive to HIV-positive transplants. Two others — Hahnemann University Hospital in Philadelphia and Mount Sinai Medical Center in New York — also are approved for the research, according to the UNOS.