Transplants Give Life to HIV-Infected

July 1, 2003

CDC HIV/STD/TB Prevention News Update

Monday, June 30, 2003

" Transplants Give Life to HIV-Infected "

Baltimore Sun (06.23.03)

Not long ago, the thought of transplanting organs into HIV-

positive patients would have defied all reason. Giving scarce

organs to patients who did not have long to live was considered

wasteful, even unethical. Yet like so many things about AIDS,

that view is slowly giving way to another: " Now, the question is

whether we can ethically exclude these patients, " said Dr.

T. Bartlett, a surgeon at the University of land

Medical Center who performed a kidney transplant on an HIV-

positive patient last month.

The unofficial moratorium on transplants for HIV-infected

patients, in force since the 1980s, is slowly being lifted as

hospital after hospital has found ways to push boundaries once

thought inviolable.

The argument for performing organ transplants on such

patients was strengthened by a study presented this year by

researchers at the University of California-San Francisco. Among

23 patients who had at least a year of follow-up after their

transplants, the survival rate was about 85 percent. Outcomes

overall were no different than one would expect among people

without the virus.

The University of land Medical Center has recruited

patients for a nationwide trial in which 75 HIV-infected patients

would receive kidney or liver transplants. One purpose of the

clinical trial is to determine which anti-rejection drugs and

which antivirals should be used and in what doses. Many doctors

believe that certain anti-rejection drugs do nothing to worsen

HIV infection while others should be avoided.

Dr. Conte, who heads the heart transplant program at

s Hopkins University, said heart transplants for people with

HIV remain risky and should be done only by institutions

participating in a clinical trial. For now, he said, the Hopkins

program is staying out of trials, preferring to reserve the

procedure for patients who stand the best chance of succeeding.

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