BALTIMORE, MARYLAND, United States – Doctors at Johns Hopkins Medicine announced on Wednesday (March 30) the first ever liver transplant from an HIV positive donor to an HIV positive recipient, as well as the first kidney transplant in the United States from an HIV positive donor to an HIV positive recipient.
Transplant surgeon Dr. Dorry Segev said he had already been performing successful organ transplants for HIV positive patients using organs from HIV negative donors when his team realized HIV positive donors’ organs might also be used, reducing the time a patient would have to spend waiting for an HIV negative organ.
“It occurred to us that there are thousands of patients with HIV in need of kidney transplants, liver transplants, etc., who were waiting on waiting lists and suffered high risks of dying while waiting for these organs that they needed. 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,” he said.
Such surgeries could not be performed, however, until a 1980s-era law that had prevented doctors from using organs from HIV-infected patients was changed.
Since the law’s change, HIV positive patients who need organ donation can opt to consider organs given by both HIV positive and HIV negative donors, thus reducing the time they might have to wait for HIV negative organs.
“For patients today, for those living with HIV, this is a very exciting time, because now instead of having a very high risk of death on the waiting list, every potential HIV positive donor is potential lives saved,” Segev said.
The patients who received the liver and the kidney and the woman who donated both organs asked that their identities remain confidential.
The surgeries took place at Johns Hopkins Hospital in Baltimore within the past two weeks.
Still in the hospital, the liver transplant patient is expected to be released in a few days, while the kidney transplant patient is already at home.
Both patients had been living with HIV for more than 25 years, according to the hospital.
Introducing an organ from an HIV positive donor into a patient’s body does present a risk for new disease exposure, Dr. Christine Durand said.
“These patients will be exposed to a second strain of HIV from the donor, and they may be secondarily infected with that strain. What that means is that we need to consider carefully whether the donors have resistant virus. So all of the recipients are going to be on HIV medications already. And so, when we consider these donors carefully and select them, we have to take into account matching regimens and matching HIV resistance patterns. So this is something we’re going to monitor for carefully over the ensuing months,” she said.
To the end of her life, the woman who donated the organs was dedicated to the cause of helping fight the disease, her family said in a statement that was read at the press conference.
“From early childhood, she always stuck up for the underdog, befriended and loved. HIV was not a choice she made, but she fought it for herself and our family every day. As we all know, HIV is a stigma, and people with the disease are unfortunately at times treated differently,” the statement said.
“With their help and the drive behind New England Organ Bank, she was able to leave this world helping those underdogs she fought so hard for.”
More than 120,000 people in the U.S. are on the waiting list for organ transplants at any one time and thousands die while still awaiting an organ donation, according to Johns Hopkins.
