April 4, 2016
On March 31, surgeons at Johns Hopkins completed the first-ever transplants between an HIV+ donor and HIV+ recipients. A kidney and liver from one HIV+ individual were transplanted into two separate HIV+ patients.
According to the US Department of Health & Human Services Organ Procurement and Transplantation Network, at around noon on Monday April 4, there were 121,161 individuals in the US waiting for an organ transplant. Ten people are added to that list every minute, and 22 people die every day waiting for an organ. Dr. Dorry L. Segev, the surgeon who completed the transplant at Hopkins, estimates that up to 600 HIV+ organs go to wasteeach year, and that transplanting them into HIV+ patients could save more than 1000 people.
In 2013, the HIV Organ Policy Equity Act (HOPE) repealed the 1988 amendment to the National Organ Transplant Act, which banned the transplantation of organs from HIV+ donors into HIV+ recipients. This followed evidence demonstrating that HIV+ patients respond to and recover from transplants at a comparable rate to HIV- patients. In January 2016, Hopkins became the first hospital approved by the United Network for Organ Sharing to conduct such transplants.
There are additional challenges to matching HIV+ donors and recipients: in particular, physicians must ensure that the donor is not infected with a more aggressive or resistant strain of HIV than the recipient. This means physicians require access to comprehensive records of the donors past medications and response to those medications, which may not always exist.
The current transplant protocol used organs from a cadaveric donor, but Dr. Segev estimates that many HIV+ individuals are healthy enough to act as living donors. Research protocols for living donations at Hopkins will be drafted up later this year. Hahnemann University Hospital in Philadelphia and Mt Sinai Hospital in NYC have both submitted applications to conduct transplants between HIV+ individuals as such organs become available.