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Lift Ban on HIV Infected Organ Transplants? HIV Patients Want Access

Lift Ban on HIV Infected Organ Transplants? HIV Patients Want Access

HIV infected patients who need replacement organs say they should be allowed to access organs from HIV positive donors and federal health officials are considering whether its time to lift the current ban on such organ transplants.

Organ damage, and particularly kidney damage, can occur due to HIV/AIDS related infections and also due to the medications those infected with HIV are put on. This means that HIV patients often require organ donations.

Long waiting lists for organs and stigma meaning that patients with HIV may be overlooked as viable organ recipients has created a push to circumvent the waiting lists and use HIV-infected organs that would otherwise not be used for organ donations.

As The New York Times reports, this change is not being rushed into but is being carefully considered:

Until recent years, H.I.V.-positive patients were not given transplants because of concerns that the virus could destabilize transplanted organs or that the immunosuppressive drugs used in transplants might make the virus more dangerous.

But a large clinical trial found that results in H.I.V.-positive recipients are “just as good as H.I.V.-negative patients, more or less,” said the study’s leader, Dr. Peter Stock, a transplant surgeon at University of California, San Francisco. “Our kidney patients do slightly worse than the general population of transplant patients, but better than kidney transplant patients over 65.”

Last year, at least 179 H.I.V-positive people received kidneys or livers, up from 9 in 2000.

Allowing H.I.V.-positive organs to be used would create an additional supply when some 110,000 Americans are awaiting transplants. They often wait years, and sometimes are too sick when organs become available to benefit from them.

There are concerns, even among some supporters of changing the law.

“People I know in the gay community are very split on it,” said Michael Bauer, 45, of Iowa City, who became H.I.V.-positive two years ago and will probably need a liver transplant in coming years. “There’s the concept that having an H.I.V-positive donor could actually be more damaging. You could have a donor who has a tougher strain of H.I.V.”

Doctors say this and other risks could probably be managed by screening out the sickest donors and recipients.

There are concerns, however, that this may lead to an increased risk of HIV infected organs entering the general donation system and therein that previously HIV negative patients may be unknowingly given infected organs.

Advocates say that recently issued stricter guidelines on how donated organs are handled should be enough to prevent such incidents, though, as with any situation like this, the potential for mistakes is always there.

The Times reports that in South Africa a small number of HIV patients have been given organs from HIV positive donors and all but one are believed to be doing well with more transplants being scheduled, so this is not unprecedented.

Also, the U.S. currently allows Hepatitis C infected organs to be used should the recipient already be infected with Hepatitis C.

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Photo used under the Morguefile Attribution License, with thanks to Click.

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30 comments

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1:00PM PDT on May 1, 2011

I say it's too risky for HIV negative patients. With so many mixups in the medical profession, such as wrong medication given to patients etc., I am against it. Even if all precautions are taken, there's always a margin (I think large) of error.

1:17PM PDT on Apr 21, 2011

There are so many different strains of HIV these days, I would think there would have to be a close match with the strain of the virus, too, in order for it to be viable.

1:18PM PDT on Apr 14, 2011

NO WAY!!!!!! TOO RISKY!!!

11:33AM PDT on Apr 14, 2011

Seems crazy to waste organs that cld be used to help others..

2:41AM PDT on Apr 14, 2011

If u had aids and was dying wont u die anyhow sooner or later? I don't see the point in dragging out such an awfull illness by a transplant. But I don't have aids and don't need a transplant so I may change my mind if it was me.

10:09PM PDT on Apr 13, 2011

All invasive procerdures carry some risk with them. That is why surgeons have patients sign consent forms. They usually mention "informed consent". It would be best left for the patient to decide if they want to take the risk.

8:24PM PDT on Apr 13, 2011

In the US where medical care is the best in the world (but also the most expensive and not everyone can afford even basic health care) it would seem that only affluent people regardless of their own health status, will be able to afford a transplant.

In Australia, were there are very long waiting lists for organ transplants, potential recipients are screened and evaluated. Those who are smokers for example are stigmatised as being less worthy of a transplanted organ and understandably transplant surgeons don't particularly want to waste their time and skills on some patients. There is also the risk of infection for all concerned in the transplant operation and indeed, some surgeons will not operate on a patient until the patient has undergone HIV testing (so the surgeon and operating staff know the risks).
Again in this country, medicine is heavily subsidised and private health insurance is widely available. We don't pay for blood. It is freely given and widely usedso that everyone benefits, not just those who can afford it.
There's an international trade in organ transplants and exploitation of poverty stricken people for those who can afford it so why is there such a movement in America?

3:50PM PDT on Apr 13, 2011

Interesting quandary.

3:43PM PDT on Apr 13, 2011

to each his own,ty

12:21PM PDT on Apr 13, 2011

Let those who may receive these organs decide what is best for them.

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