According to an extensive study, people with HIV can safely accept donated kidneys when the deceased donor has the virus. The U.S. government is looking for ways to expand the practice. It could help reduce waiting times for organs regardless of HIV status.
This new study, published in the New England Journal of Medicine on Wednesday, examined 198 kidney transplants across the U.S. The researchers found that the results were the same whether the organ was donated by a patient with or without AIDS.
The Department of Health and Human Services (HHS) proposed last month a rule permitting these kidney and liver transplants to be performed outside of research studies. The final rule will apply both to living donors and dead ones. The rule could be implemented in the next year if it is approved.
The participants in this study had HIV, and kidney failure, and consented to receive an organ either from an HIV-negative deceased donor kidney or an HIV-positive deceased donor kidney, depending on which kidney was available first.
Similar survival rates
Researchers followed recipients of organs for up to 4 years. Researchers compared kidneys from HIV-positive donors to those donated by non-HIV donors.
The rates of survival in both groups were similar, as was the rate of rejection of organs. The virus levels of 13 HIV donors and four recipients in the second group rose, mainly because they did not take their HIV medication consistently. In all cases, the levels returned to undetectable or very low levels.
This study shows the incredible safety of these transplants and their fantastic results, said Dr. Dorry Segev from NYU Langone Health.
South African surgeons provided the first proof that HIV-positive organ donors are safe for HIV-positive people in 2010. In the United States, however, the practice was not allowed until 2013, when Segev urged the government to lift the ban on research and allow the studies. Initially, studies involved deceased donors. Segev, along with others from Johns Hopkins University Baltimore in Baltimore, performed the first-ever kidney transplant in history using a living HIV-positive donor.
In the U.S., there have been 500 kidney and liver transplants performed from HIV-positive donors.
‘A win-win’
The stigma of HIV and the outdated laws that criminalize organ donation by people living with HIV has actively discouraged those with HIV from becoming organ donors, according to Carrie Foote, an Indiana University professor in sociology. Foote is HIV-positive and registered as an organ donor.”We could help those of us with HIV, but we also free up our organs to allow others who do not have HIV faster access to organs.” All parties are in a win-win situation.
According to U.S. statistics, more than 90,000 people are waiting for kidney transplants. Organ Procurement and Transplantation Network. More than 4,000 patients will die in 2022 while waiting for kidneys.
Elmi Muller, a South African professor at Stellenbosch University predicted in an editorial that the study would have “far-reaching effects” in countries that do not transplant these organs.
Muller wrote that the pioneer of this practice had “above all” taken a step towards fairness and equal treatment for HIV-positive people.
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