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Thursday, April 21, 2011

Allowing HIV positive people to donate organs

Currently, there is a federal ban preventing HIV-positive people from donating organs after death. Dorry Segev and his colleagues from Johns Hopkins think that ban should be lifted, but only for HIV-positive recipients.

Perhaps because AIDS is a largely manageable disease today and no longer the death sentence it once was, hundreds of HIV-positive patients now languish on organ donor lists, sometimes for years. The very medications that are prolonging their lives can sometimes cause severe enough damage to their livers and/or kidneys to require organ replacement. In general, those lucky enough to receive new organs have had good outcomes. The hard part is to survive long enough to be matched with a donor.

In the meantime, an equivalent number of HIV infected people with transplantable organs die each year. If those organs were given to the HIV infected patients on the donor list, not only would there be enough to go around, but it would free up the non-HIV infected organs for HIV-negative recipients.

There are a few major problems to be overcome before this practice can be sanctioned. First, precautions must be in place to ensure that no HIV organs get accidentally transplanted into HIV-negative patients. Second, doctors must take care not to introduce more aggressive strains of HIV into their patients.

Sergev and his team are confident that these safeguards can be met. They draw on lessons learned from transplanting hepatitis C infected organs only into hepatitis C infected recipients, a practice that has been highly successful. A change in HIV donation policy would require an act of Congress, who might take some convincing.