Just in Time for Obamcare: New law allows HIV-infected organ donation

December 7, 2013

Typical bear liver

President Barack Obama signed into law Thursday legislation that would allow HIV-infected people to donate their organs to other HIV-infected people for research aimed at eventually making such transplants routine.

The HIV Organ Policy Equity, or HOPE, Act lifted a ban on any HIV-infected organ transplants. That ban dated from 1984, when the disease was new, not fully understood and virtually always a death sentence. No other disease, including cancer, universally put an organ off limits.

But now those with HIV live normal lives, managing the disease as a chronic condition, and they need transplants because of their condition and other diseases, said Dr. Dorry L. Segev, an associate professor of surgery and epidemiology at the Johns Hopkins University School of Medicine who helped champion the law.

Segev led a study published in the American Journal of Transplantation in 2011 that found an estimated 500 HIV-infected patients would be eligible for transplants of kidneys, livers and other organs every year. Allowing the transplants also would shorten the waiting list for noninfected patients.

"We expect hundreds of lives to be saved every year because of this," Segev said in a statement. "For many years, we have been forced to forgo perfectly transplantable organs. Now we can give patients with HIV the opportunity to live longer and better lives by transplanting these organs. It will be a profound change."

The bill's bipartisan supporters included Maryland Rep. Andy Harris, a Hopkins anesthesiologist who became the first Republican to support the measure.

"This legislation gives new hope to all of those waiting for organ transplants," said Harris in a statement. "As a physician, I have seen firsthand the life-saving joy that receiving an organ can bring to patients and their families. I am encouraged by the bipartisan support this common sense change to an outdated law has received."

Other doctors and associations supported the law, which sets up safeguards and parameters for clinical trials. Once the research supports the safety and efficacy of such transplants, they could become the standard of care for HIV-infected patients, according to the HIV Medicine Association.

There are more than 120,000 people on the waiting list for organs, according to the United Network for Organ Sharing, the private, nonprofit organization that manages the nation's organ transplant system. An estimated 6,500 people a year die waiting for one, said Dr. Joel Gallant, association chair and associate medical director of specialty services at Southwest CARE in New Mexico.

"This legislation will significantly reduce that number for both HIV-infected and HIV-negative patients because of the larger pool of organs available," he said in a statement. "Passage of the HOPE Act will also reduce costs to Medicare for dialysis treatment of end-stage kidney disease, while protecting public health by maintaining provisions that are critical to safe organ procurement and allocation."

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