For The First Time, HIV-Positive Patients Can Receive And Donate Organs
The wait for an organ transplant is exactly what we all know it to be—a looooong wait, and an anxiety-ridden one at that. Although being at the top of one of these lists is promising, other factors like beating the clock and wondering whether your body will reject the organ are very much alive and well. A recent finding, however, might help bring some relief to those who are further down on this dreaded list.
Thanks to a successful organ transplant between an HIV-positive donor and HIV-positive patient that took place last week, anyone who’s HIV positive and in need of an organ transplant is no longer a hopeless case. Dr. Dorry Segev, who has been working towards this goal for six years, led the team at Johns Hopkins University that performed the surgery. Up until 2013, Segev’s vision wasn’t even possible.
In 1988, during Regan’s office (you guessed it), the National Organ Transplant Act (NOTA) was passed, which made it illegal for people with HIV to donate their organs. These patients were already prohibited from donating organs to those who weren’t infected with the virus, and the general assumption at the time was that, if they donated to someone with HIV, that would only further hurt the patient’s immune system. And so it was outlawed. The thing is, by the 1990s, living with HIV meant living a longer life compared to when the epidemic first spread and now, with proper treatment, those who are HIV-positive can live a relatively normal life.
“It occurred to us that there are thousands of patients with HIV in need of kidney transplants, liver transplants, who were waiting on waiting lists and suffered high risks of dying while waiting for these organs,” said Segev. “And at the same time, we were throwing away organs from donors infected with HIV just because they were infected with HIV. These were potentially perfectly good organs for these patients.”
In 2010, doctors in South Africa were already successfully transplanting organs of HIV-positive donors, but at this time, the NOTA ban was still in place. In 2013, Obama finally reversed the ban, thanks to the HIV Organ Policy Equity Act (also known as the HOPE Act), ultimately allowing Segev to successfully complete the surgery.
An HIV-positive donor who passed earlier this month donated her kidney and liver to two other HIV-positive recipients, and one of them is already home from the hospital. Although these surgeries hold a monumental amount of hope, there are still varying levels of resistance with HIV that factor in when supplying an organ to a donor. The HIV strain has to be a match to the recipient.
“We want to make sure,” said Segev, “that we don’t take people who have a relatively nonresistant form [of HIV] and then give them something from a donor who had pretty high-resistance patterns, thereby requiring them to make major changes to their regimen, and maybe even have an HIV that would be less easy to control.”
Segev’s lifesaving surgery was a long time coming. With a finite amount of organs and a growing list of people in need, this breakthrough is going to save lives–and change history.
Images via US News, illustrations by Mathieu Beaulieu, original imagery by Kathryn Chadason
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