April 18, 2011
An estimated 500 to 600 HIV-infected livers and kidneys would become available annually if not for a 23-year-old amendment to the National Organ Transplant Act, according to a new study co-authored by Johns Hopkins' transplant surgery director of clinical research. "We have a huge organ shortage," said Dr. Dorry Segev. "Every HIV-infected one we use is a new organ that takes one more person off the list." Some 110,000 Americans are awaiting transplants.
The ban on transplanting organs from HIV-infected patients was passed in 1988, when AIDS was considered a death sentence. But people with HIV/AIDS now are living long enough to develop liver and kidney problems, adding to the demand.
"We would like to see as many safe transplants occurring as possible, and there's no reason why HIV-positive recipients shouldn't get transplants and that HIV-positive donors can't be used," said Dr. Matthew Kuehnert, head of CDC's Office of Blood, Organ and Other Tissue Safety.
Until recently, HIV-positive patients were not given transplants out of concern the virus could destabilize transplanted organs or that the required immunosuppressive drugs could make HIV more dangerous. But a large clinical trial led by Dr. Peter Stock of the University of California-San Francisco found results in HIV-positive recipients are "just as good as HIV-negative patients, more or less."
The only known transplants involving HIV-positive donors and recipients have been performed by Dr. Elmi Muller, a surgeon in Cape Town, South Africa. Only one of Muller's 10 transplant patients has experienced rejection problems.
CDC and other U.S. health agencies are working on new guidelines that call for research into transplanting HIV-positive organs into HIV-positive patients. The transplant ban, however, would have to be lifted before this work could begin.