United States – HIV-positive individuals should be allowed to get donated kidneys from deceased individuals also infected with the virus, a study has suggested amid the US government’s attempts to extend the practice. That could help reduce the time people, irrespective of whether they have HIV or not, have to wait for the organs.
Study Supports HIV-Positive Kidney Transplants
The new study, which was done on 198 kidney transplants across the United States and published on Wednesday in the New England Journal of Medicine, revealed that similar outcomes of transplants could be marked irrespective of whether the donated kidney was sourced from an AIDS virus carrier or not, as reported by Associated Press.
Last month, the Department of Health and Human Services issued a proposed rule change to expand the use of such organs in kidney and liver transplants outside of research trials. A final rule was going to cover both living and deceased donors. If approved, it could start the next fiscal year, which is in the coming year.
They were HIV positive, struggling with end-stage renal disease, and willing to accept any available kidney –either from an HIV+ donor or an HIV-negative donor.
Humans followed the recipients of the organs for up to four years. To do so, they paired the matched half who received kidneys from HIV-positive donors with a similar matched half who received their kidneys from donors without the virus.
Both groups had comparable high five-year overall survival and low rates for acute rejection of the transplanted organs. Thirteen patients in the HIV donor group and four in the other group had an increase in virus levels common due to noncompliance with HIV medications, and all the levels returned to very low or non-detectable.
“This demonstrates the safety and the fantastic outcomes that we’re seeing from these transplants,” said study co-author Dr. Dorry Segev of NYU Langone Health.
Comparable Outcomes for HIV-Positive and HIV-Negative Donors
South African surgeons offered the initial proof in 2010 that transplantation of HIV-positive donor organs is feasible in HIV-positive patients. However, common the practice is internationally, the technique was not permitted in the United States until 2013 when the government prohibited the practice but granted permission for research purposes only after the lobbying of Segev. Initially used with cadaveric donors – meaning the organs came from a recently deceased person. Then, in 2019, Segev and his team at Johns Hopkins University in Baltimore did the world’s first live donor kidney transplant.
So far, 500 kidney and liver transplants have been performed in the U.S. where the donors too were HIV-positive.
Breaking the Stigma and Expanding the Organ Pool
HIV-positive individuals have been intentionally dissuaded from becoming organ donors by the stigma and archaic state laws and policies that penalize organ donation for persons with HIV, according to Carrie Foote, a professor of sociology at Indiana University in Indianapolis.
“Not only can we help those of us living with this disease, but we free up more organs in the entire organ pool so that those who don’t have HIV can get an organ faster,” said Foote, who is HIV positive and a registered organ donor.
Urgent Need
This was revealed by the U.S. Organ Procurement and Transplantation Network, stating that over 90,000 persons are waiting for kidney transplants. As we approach the next year, or exactly 2022, thousands of people die while waiting to receive kidney transplants.
A Step Toward Global Change and Fairness
In an editorial in the journal, Dr. Elmi Muller of Stellenbosch University in South Africa made the observation that the new study would give “proportions that will impact many countries,” which do no transplantations with these organs, as reported by Associated Press.
“Above all, we have taken yet another step toward fairness and equality for persons living with HIV,” wrote Muller, who pioneered the practice.