By: China Magno, Larry King Now
Last Wednesday, a team of surgeons at Johns Hopkins University medical center announced the success of two landmark surgeries. The operations involved the transfer of HIV-positive organs to HIV-positive patients, marking the first operation of its kind.
HIV-positive individuals willing to donate their organs for use have been continually rejected because of an outdated federal ban established by the National Organ Transplant Act in 1988. At the time, a diagnosis of HIV was considered a death sentence and it was believed that using an organ from an HIV-positive donor might actually do more harm than good.
For the past six years, Dr. Dorry Segev – a transplant surgeon who led the team that performed the recent operations – and his colleagues have made many trips to Capitol Hill, working tirelessly to overturn the ban.
“It occurred to us that there are thousands of patients with HIV in need of kidney transplants, liver transplants, who were waiting on waiting lists and suffered high risks of dying while waiting for these organs," says Segev. "And at the same time, we were throwing away organs from donors infected with HIV just because they were infected with HIV. These were potentially perfectly good organs for these patients."
In the 1990s, as doctors began to have a better understanding of the virus thanks to the advances in science and technology, improved forms of treatment became available, allowing HIV-positive individuals to live longer. Unfortunately, individuals infected with the virus are more likely to experience liver and kidney failure. So as HIV-positive individuals began to live longer, this also meant that more of them needed organ transplants.
A 2010 study found that transplant recipients with HIV did about as well as recipients who were HIV-negative. Also during this time, doctors in South Africa - where nearly 20 percent of adults under age 50 have HIV - had started successfully transplanting HIV-positive organs. Here in the U.S., not until 2013 was the 1980s legal ban on such transplants reversed. The legislation – the HIV Organ Policy Equity (HOPE) Act – was introduced to Congress in early 2013 and approved and signed by President Obama that November.
Dr. Peter Stock, a transplant surgeon at the University of California, San Francisco, says that the ability to perform transplantations of HIV-infected organs could be helpful for everyone as it may reduce the waiting time for all potential organ recipients. According to the Organ Procurement and Transplantation Network, there are 121,272 patients on the waiting list. A name is added every 10 minutes and each day an average of 22 people die waiting for transplants that cannot take place because of the shortage of donated organs. On the other hand, in a 2011 study published in the American Journal of Transplantation, Dr. Segev found that 500 to 600 HIV-infected donors annually would be eligible to donate kidneys, livers and other organs if the prohibition were lifted. If many people with HIV opt for the shorter wait period that getting an HIV-positive organ entails, this would mean that uninfected individuals will also move up in line, saving about 1,000 lives each year.
This success story underscores the extent to which HIV/AIDS continues to be a pressing health issue, a reality many Americans seem to be unaware of.
Hayley Gorenberg, deputy legal director for Lambda Legal – a civil rights organization that serves the lesbian, gay,bisexual, and transgender communities, and people with HIV – called the transplants a “triumph of science over stigma.”
Indeed, a triumph over the stigma surrounding HIV/AIDS has been made, but the mere prevailing existence of said stigma, is much more telling. In a 2015 episode of ‘Larry King Now’ an expert panel joined Larry to discuss the state of HIV/AIDS in America: how close we are to a cure, the prevailing stigma, and why – when 1.2 million Americans live with HIV – the fight to end the epidemic isn’t prioritized on our nation’s to-do list.
Jake Glaser, Elizabeth Glaser Pediatric AIDS Foundation Spokesman, and Sheryl Lee Ralph, HIV/AIDS activist, discussed with Larry how the stigma surrounding HIV/AIDS is in fact growing, particularly in the LGBT and African-American communities.
The panel also discussed how this stigma among other factors including discrimination, racism, and transphobia can keep people disconnected from care. In the clip below, ‘The Advocate’ editor-at-large Diane Anderson-Minshall explains why transgender women are 49 times more likely to be HIV positive than the general population and how the factors previously mentioned are to blame.
As a nation, we have come a long way since the 1980s, a time characterized by the ostracizing of infected individuals as a result of limited understanding about HIV/AIDS. Today, after many medical and scientific breakthroughs, doctors have a much greater understanding of the disease and an HIV diagnosis is no longer a death sentence. But the stigma still largely exists, particularly surrounding the LGBT and African-American communities.
The recent success of the two HIV-positive organ transplantations is indeed a triumph that deserves celebration. Thanks to the persistent efforts of a group of impassioned Maryland doctors, hope can now be offered to not only HIV-infected individuals struggling with liver and kidney failure, but for all potential and resilient organ recipients on the transplant waiting list.
The views and opinions expressed herein are those of the author's alone and do not necessarily reflect the views of Ora Media, LLC, its affiliates, or its employees.
