Surgeons Seek Repeal of Transplant Ban Between HIV-Positive People

Surgeons Seek Repeal of Transplant Ban Between HIV-Positive People
By Randy Dotinga

HealthDay Reporter

WEDNESDAY, June 27 (HealthDay News) -- Transplant surgeons plan to meet with U.S. Congressional staff members Wednesday to push for the repeal of a law that forbids HIV-positive patients from getting organ transplants from other HIV-positive people.

If the law is changed, patients infected with the AIDS-causing virus will have more organs available to them for transplantation, advocates say.

"We want to save lives of people with HIV who may otherwise die on the waiting list for organs," said Kimberly Crump, policy officer of the HIV Medical Association, a group of AIDS doctors and researchers.

Crump said the advocates hope to encourage lawmakers to sponsor a bill calling for the law's repeal.

However, hurdles exist. For instance, questions remain about the health risks of transplanting organs between HIV-positive patients, and research is needed to make sure such transplants are safe, experts say. And some transplant surgeons refuse to perform transplants on HIV-positive patients.

Specialists, including Dr. Dorry Segev, director of clinical transplant research at Johns Hopkins School of Medicine, will discuss the special transplant needs of HIV-positive patients at the lunchtime meeting.

HIV-positive patients are vulnerable to a variety of diseases that can threaten their organs if their immune systems weaken. For example, they're susceptible to hepatitis B, which worsens faster in HIV-infected people than others and can lead to liver disease and the need for a liver transplant, explained Dr. Margaret Ragni, a professor of medicine at the University of Pittsburgh Medical Center.

HIV-positive patients are also susceptible to developing kidney problems that require kidney transplants.

HIV-positive patients can receive organ transplants from people who aren't infected with HIV, but federal law banned transplants between HIV-positive patients in the 1980s during the AIDS crisis.

Ragni said medical officials have had a variety of concerns, including fears that the recipients may receive a stronger viral strain from a donor and get sicker, that HIV-related infections could be transmitted during the transplant, or that an organ from an HIV-positive donor may accidentally get transplanted into a patient who doesn't have the virus.

A coalition of medical associations and advocates for AIDS patients, including amfAR, the Foundation for AIDS Research and Human Rights Campaign, maintain that the law is outdated and denies HIV-positive patients access to more opportunities for organ transplants.

Researchers estimate that changing the law could pave the way to saving the lives of 1,000 HIV-positive patients each year in the United States.

Advocates also say a law change will mean that patients who aren't infected with HIV will have quicker access to organs because HIV-positive patients will have a wider array of options.

But even if the law changes, some issues would still need to be resolved, said Dr. Lynda Frassetto, an internist and kidney specialist at the University of California, San Francisco.

Transplants between HIV-positive patients are still experimental, although promising research has been conducted in South Africa, Frassetto said.

Also, some transplant surgeons prefer not to treat HIV-positive patients, Frassetto said. "The transplant surgeons I work with say that some transplant groups don't want to transplant HIV patients," she said. "They don't want to be exposed to the blood and don't have the infrastructure in place to handle the complicated problems they get."

Recently, a panel of U.S. Department of Health and Human Services experts voted to uphold a decades-old ban on gay men donating blood, while advocating for more research on the controversial
issue. Advocates say that improved screening techniques make the ban unnecessary.

More information
For more about organ transplants, see the U.S. National Library of Medicine.

(SOURCES: Kimberly Crump, policy officer, HIV Medical Association, Arlington, Va.; Margaret V. Ragni, M.D., professor, medicine, University of Pittsburgh Medical Center; Lynda A. Frassetto, M.D., internist, University of California, San Francisco)

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