HIV And Organ Transplant

A recent article in the New York Times brings up the question of whether HIV positive individuals should be able to receive organs from infected donors - something which is currently illegal in the U.S. The debate is fueled by the ongoing shortage of donor organs, which could be significantly relieved by allowing transplants from HIV infected donors. Doing so would probably also help HIV infected recipients move up on the transplant list.

At least one state, Illinois, is willing to give the idea a go, although they are currently prohibited by federal law. That said, the idea of transplanting a chronically infected organ is not completely new. Individuals with hepatitis C can already donate their livers to recipients who also have the virus. Still, some concerns about the process include infection with more robust strains of HIV, problems with the immuno-suppressant drugs required after transplantation, and the possible release of infected organs into the general transplant pool.

The CDC is about to release guidelines encouraging research on the topic of HIV infected organ transplants, and it will be interesting to see if more robust studies confirm preliminary results that they may work relatively well. That said, I understand why the idea is a little hard for some people to wrap their brains around. As someone who grew up during the early years of the AIDS epidemic, it's sometimes difficult to remember that HIV is becoming a chronic disease that people can live long, healthy lives with.

On the other hand, it's impossible for me to not be aware of how many people die each year from a lack of available organs. That's why the endgame for this process may turn out to be bigger than donating HIV infected organs to people who are already HIV positive. It may involve profound legal and ethical questions about the costs and benefits of choosing to live with HIV rather than die of organ failure.

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