Ban on Transplanting HIV-Infected Organs Should Be Lifted, Researcher Says

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If Congress reversed its ban on allowing people with HIV to be organ donors after their death, approximately 500 HIV-positive patients with kidney or liver failure each year could get transplants within months instead of years, according to researchers.

If this legal ban were lifted, we could potentially provide organ transplants to every single HIV-infected transplant candidate on the waiting list,” said Dorry Segev, MD, PhD, Associate Professor of Surgery at Johns Hopkins University in Baltimore. “Instead of discarding the otherwise healthy organs of HIV-infected people when they die, those organs could be available for HIV-positive candidates.”

Not only would HIV-positive transplant candidates get organs sooner if such transplants were legalized, but by moving them off the waiting list, the time to transplant would be shorter for non-HIV-infected patients, Dr. Segev said. In 2009, more than 100 HIV-positive patients received new kidneys and 29 received new livers. It is well established that HIV-infected patients may encounter accelerated rates of liver and kidney disease due in part to toxic effects on antiretroviral therapy.

The ban on organ donation by HIV-positive patient is a relic of the 1980s, according to Dr. Segev. Congress has not updated the ban since it was enacted. Yet, the treatment paradigm for HIV has changed dramatically.  Dr. Segev and his colleagues conducted a study in which they estimated the number of people who die each year in the United States who are good potential organ donors except for that they are HIV-positive. Their findings appear online in the American Journal of Transplantation.

While no transplants of HIV-infected organs into HIV-infected patients have been done in the United States because of the ban, Dr. Segev said doctors in South Africa have started doing this type of transplant with excellent results.  These types of transplants are not without concerns, however.  Physicians need to make sure that the harvested organs are healthy enough for transplant and that there is minimal risk of infecting the recipient with a more aggressive strain of the virus.

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