HOPE for HIV-infected patients awaiting life-saving organ transplants

In1984, Congress passed the National Organ Transplant Act, which banned HIV-infected people from donating their organs for transplantation after death. Despite steady advances in HIV diagnosis and treatment, the ban remained in place until last month, when President Obama signed the new HIV Organ Policy Equity (HOPE) Act. The legislation allows researchers to study whether and how organ transplants between HIV-positive persons can be done in a safe way.

Efforts to change the law came after researchers at the Johns Hopkins University School of Medicine published a landmark scientific paper in 2011, which estimated that 500 HIV-infected patients would be eligible for life-saving transplants each year if the ban were overturned. Working with politicians on both sides of the congressional aisle, researchers also found that allowing those transplants would also shorten wait times for non-HIV-infected patients.

The study was published in the American Journal of Transplantation by Johns Hopkins transplant surgeon Dorry L. Segev and research assistant Brian J. Boyarsky. "For many years," said Segev, "we have been forced to forego perfectly transplantable organs. Now we can give patients with HIV the opportunity to live longer and better lives by transplanting these organs."

Many HIV-infected patients face chronic conditions common among non-infected people, including liver and kidney failure. For the non-infected people, organ transplants are the standard of care. But many patients die waiting for an organ to become available. Currently, there are 120,000 people on the waiting list for organs in the United States. And while the HOPE Act won't significantly reduce the number of people on that waiting list, it is still a step in the right direction.

The original 1984 ban, said Segev, is a "relic." Obama issued a similar statement, calling the policy "outdated."

Until now, only South Africa has allowed the transplantation of HIV-infected organs into HIV-infected patients, and its experience is relatively limited. Segev said that the new law will quickly turn the United States into the world leader in understanding and managing HIV organ transplantation.