PHILADELPHIA (KYW Newsradio) — In his weekly conversation with KYW's Michelle Durham, KYW Medical Editor Dr. Brian McDonough explains that, due to advancements in HIV treatment, people who are HIV-positive can now donate organs for recipients who are also HIV-positive.
This is a dramatic change from the past, when organ donation was not considered possible for people who were HIV-positive because of the risk of spreading the virus. And it is significant, because it opens up a new pool of organs for HIV-positive patients in need of a transplant.
People living with HIV can now live long, productive lives, thanks to ongoing advancements in treatment in medicine. And the treatments for HIV do not negatively interact with the immunosuppressive drugs needed for organ recipients post-transplant.
Studies and practice are currently limited to kidney and liver transplants, but there is great new potential for saving lives.
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Organ transplants safer and more accessible
Michelle Durham: Today I'm going to ask Dr. Brian a question. I came across a published article where it is indicated that people with HIV are going to be able to donate their organs to others who have HIV. And this is a first. This is a change. So can you explain this to me?
Dr. Brian McDonough: Sure, if you go way back in history, when HIV first was detected and it was linked with AIDS, there was no organ transplantation at all from anyone who was HIV-positive or who had AIDS. And at that time, very good reason — because you would spread the virus. There was no treatment. At that time, AIDS was a death sentence.
Fortunately, since then, HIV is more like a disease like diabetes, in some ways now. We can control it with all the medications that are out there. So the fear of HIV is not as great as it was when it progressed to AIDS.
So the organ donation issue kind of stayed where it was. No one with HIV was ever going to donate an organ to anyone else, including those with HIV.
In parts of the world where there weren't sophisticated tools and technology and ways to get organs — especially in South Africa and other areas — they started testing HIV-positive organs in HIV-positive patients and found that, actually, people were doing quite well. In other words, they lived with it.
So about 2013, they started studying this phenomenon, and they basically said, in a study setting in the United States: If someone is close to death who has HIV — and they could be dying for any reason — they could get an organ from someone else who was HIV-positive. And in those studies, they found that it was safe and that the people who were studied did no worse than those who got organs from people who were HIV-negative.
So we're at a point now where they've opened it up and they said: If someone is HIV positive and they need an organ, they can get an organ from an HIV-positive person. Now, somebody who's not HIV-positive still can't get an organ from someone who's HIV-positive, but those who are can do it in the examples of kidney and liver.
The theory is that, if it's just as safe, this is going to open up more organs for everyone, because a whole new pool of organs are available.
I think this is incredible for a number of reasons. If you think about those who happen to have HIV, they weren't able to get an organ transplant, and now they're going to have that opportunity, and it's just an amazing process.
Dr. Brian: It's great, because what it's really saying is we now know, if you have HIV, you can live a long life and take medications and have a very productive life. So why would you not be able to get an organ? And why would you not get an organ from someone who's HIV-positive?
Even if it's a different strain of HIV, the studies showed, it doesn't make any difference, because the medications we have to treat HIV and to prevent AIDS are very good, and they don't interact negatively with the immunosuppressive drugs that are necessary to keep the organ in your body. So this has really been tested extensively before they would ever open it up to people outside of a test setting.
They've only studied it in kidney and liver, so they're not going to expand it beyond that — because, you know, if you don't study it, you don't necessarily know if it's safe.