Banning HIV Organ Donation

HIV-infected organ donation could save lives

April 2, 2011 / Author:  / Reviewed by: Joseph V. Madia, MD

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(dailyRx News) Researchers from Johns Hopkins believe that a law banning HIV patients from donating their organs to living HIV-positive patients is outdated.

If the ban were reversed, hundreds of HIV-positive patients who need an organ could get their transplant within months instead of years.

A law passed by Congress in the 1980s does not allowing people with HIV to become organ donors after they die. If this law were repealed, it is possible that organ transplants would be available to every HIV-positive patient on the waiting list, says Dorry L. Segev, M.D., Ph.D., an associate professor of surgery at the Johns Hopkins University School of Medicine.

In fact, repealing the law would not only help HIV-positive patients get the organs they need, but it also would free up space on the waiting list, making the wait shorter for patients without HIV infections.

"Reversing this organ donation ban will save lives."

Segev and colleagues wanted to find out the number of people who die each year in the U.S. who would be good organ donors except for being HIV-positive.

Depending on where the researchers found their data, there were around 500 deaths each year of HIV-positive people who would be suitable organ donors.

Segev believes that removing the ban will have immediate effects. Initially, there will be more HIV-infected organs than people who need them.

But as doctors start to realize that their HIV-positive patients don't have to wait years for a transplant, more patients will sign up for the shorter waiting list for HIV-infected organs.

There are some concerns about using HIV-infected organs. For example, some fear that an HIV-infected organ could be placed accidentally in someone who is HIV-negative.

Others are concerned that an infected organ could give an HIV-positive recipient a more aggressive form of the HIV virus.

However, in-depth testing of the organs before transplant will help avoid problems like these. We can also learn from what is already being done with hepatitis C-infected organs. These organs are always clearly labeled so as not to mix them up with non-infected organs.

Speaking generally of the need for more organ donors, Michelle Segovia of the Texas Organ Sharing Alliance says, "With more than 110,000 men, women and children awaiting a life saving transplant and 18 dying each day, researchers are looking for options to help solve the critical organ shortage."

Please help save lives by registering to be an organ donor. You can find your state’s registry at www.donatelife.net

Currently in the United States, an estimated 1.1 million people are infected with HIV (Human immunodeficiency virus), the virus that causes AIDS (acquired immune deficiency syndrome). HIV is transmitted through sexual contact of bodily fluids (blood, semen) with mucus membranes (oral, vaginal, anal), and the introduction of infected blood products into the bloodstream (commonly sharing intravenous needles, less commonly blood transfusions). Mothers with HIV transmit the infection to their child in utero about 25% of the time in the absence of treatment. Early infection with HIV may produce flu-like symptoms of fever, nausea and vomiting, headache, and fatigue, then disappear. HIV may take up to ten years to progress to AIDS. The virus destroys CD4+ white blood cells and opens the body up to diseases and infections that the body would normally be able to fight off (pneumocystis pneumonia, cytomegalovirus, fungal infections, toxoplasmosis) and rare cancers (Kaposi's sarcoma, Burkitt's lymphoma, primary lymphoma in the brain). Diagnosis of HIV is made by a simple blood test, and AIDS is diagnosed by a CD4+ count of less than 200/microliter (normal is 500-1500). Treatment of HIV is called highly active anti-retroviral therapy (HAART) and includes hundreds of options to stop the replication of the HIV virus (Zidovudine, Lamivudine, Tenofovir, Efavirenz, Kaletra, Reyataz)

The Johns Hopkins study appears online in the American Journal of Transplantation