Hopkins to perform first HIV transplants

The Johns Hopkins Hospital recently revealed that it is ready to perform kidney and liver transplants between HIV-positive donors and HIV-positive patients. The hospital, which received approval to conduct this procedure from the United Network for Organ Sharing, will be the first hospital in the U.S. to perform an HIV-positive kidney transplant and the first in the world to perform an HIV-positive liver transplant.

This development is predicted to have a life-changin impact on HIV-positive patients and to shorten organ donation waiting lists for all potential organ recipients.

It has been estimated that organs from 500 to 600 HIV-positive potential donors go to waste each year. These organs could be used to save more than 1,000 people, which means this development could prompt the greatest increase in organ transplantation in the past decade.

“This is an unbelievably exciting day for our hospital and our team, but more importantly for patients living with HIV and end-stage organ disease. For these individuals, this means a new chance at life,” Dorry Segev, associate professor of surgery at the Johns Hopkins University School of Medicine, said in a press release.

Trina Schroer, a biology professor at the Homewood campus, also expressed her excitement over the recent announcement.

“Obviously anything that can help people that are in need of an organ donation is a good thing,” Schroer said. “In general I think that’s a wonderful idea.”

HIV-positive transplants were forbidden from 1988 until President Obama signed the HIV Organ Policy Equity (HOPE) Act into law in November 2013. The HOPE Act was drafted by physicians and researchers like Segev. The Johns Hopkins Hospital received approval to conduct HIV-positive organ transplants from the United Network for Organ Sharing earlier this month and is prepared to perform a transplant as soon as appropriate organ donors and recipients can be matched.

“Organ transplantation is actually even more important for patients with HIV since they die on the waiting list even faster than their HIV-negative counterparts,” Segev said in the release. “We are very thankful to Congress, Obama and the entire transplant community for letting us use organs from HIV-positive patients to save lives instead of throwing them away as we had to do for so many years.”

In the past, HIV-positive patients would receive organs from donors without HIV. Therefore, with more organs donated by HIV-positive patients, even HIV-negative patients will be bumped up the waiting list for organs. However, it is important to note that patients without HIV will not receive organs from HIV-positive donors.

According to Segev, the first main focus for Hopkins will be on deceased donors. He noted that more studies will need to be done to ensure that it is safe for an HIV-positive patient to donate a kidney.

“People want to leave a living legacy; They want to help,” Segev said. “And to be stigmatized and told, ‘You can’t help because you’re HIV-positive’ can be devastating. This removes yet another stigma associated with HIV.”

Some medical experts and researchers have expressed concern that HIV-positive donors could be accidentally transplanted to patients without the virus. In other words, there is a chance that HIV-related infections can be transmitted through transplants. Schroer also outlined several other health concerns that could be associated with the organ transmission.

“Some HIV-positive individuals have other chronic infections, so that kind of thing is going to have to be carefully screened,” she said. “Another slight concern that I had when I read about this is that every person’s HIV is different... you can have one strain and then you can get another strain that has resistance. But that all can be controlled for by looking at the person’s circulating virus and making sure they’re a good match.”

Schroer expressed confidence that the researchers at the Johns Hopkins Hospital would be able to prevent these problems. Additionally, the hospital stated that it has worked for two years to cement its HIV-positive transplant policies with key health organizations and is pledging to keep the process safe.

Public Health Student Forum member and freshman Indu Radhakrishnan said that, despite the possible risks, she believes the benefits of the transplantation will outweigh any of its negative consequences.

“I feel like it’s a long time coming, and I’m glad the hospital is finally taking this next step to save lives,” Radhakrishnan said. “I wholeheartedly agree with what Segev and Johns Hopkins plan to pursue.”