New Life-Saver for HIV Patients: Transplants
October 21, 2009
HIV infection is no longer an automatic reason for denying organ transplantation to patients who are otherwise candidates for the surgery. Since 1989, more than 500 transplants have been performed in patients known to have HIV, according to the United Network for Organ Sharing, the Richmond, Va.-based organization that manages the country's transplant system.
"Patients with HIV who meet the transplant criteria should be considered for transplant," said Dr. Tony D'Alessandro, liver transplant director at the University of Wisconsin Hospital.
Advances in medical care and fading stigma against HIV have helped make organ transplantation among HIV patients more commonplace. According to a report by CDC, a person diagnosed with HIV in 2005 could expect to live another 23 years, up from 11 years in 1996. The increase in longevity is, in large part, the result of advances in antiretroviral therapy and disciplined management of HIV infection, doctors say.
In addition, doctors no longer believe the immunosuppressants that transplant recipients must take to prevent organ rejection are too dangerous for HIV patients. Recent research suggests that if an HIV infection is well-managed, the addition of immunosuppressants appears to have no negative effects.
Most organ transplants in persons with HIV have been done during the past five years, and virtually all were kidney or liver procedures.
Dr. Peter Stock of the University of California-San Francisco, leads a National Institutes of Health study of some 275 HIV-positive transplant patients around the country. About 94 percent of kidney transplant patients in the study were still alive three years after the surgery. Some 83 percent had functioning kidneys at that time, while some had to return to dialysis. These outcomes are comparable to those for patients without HIV, Stock said.
HIV infection does appear to produce poorer outcomes in liver transplant patients, particularly if the HIV-positive patient also has hepatitis C. Outcomes for HIV-positive patients with hepatitis B appear to be comparable to those of HIV-negative transplant patients.
Wisconsin State Journal (Madison)
10.07.2009; David Wahlberg
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.