This rule removes unnecessary barriers to kidney and liver transplants, expanding the organ donor pool and improving outcomes for transplant recipients with HIV
Those with HIV needing a kidney or liver transplant will now be able to receive an organ from a donor with HIV under a new rule, US health officials announced. Before this, such surgeries were only done as part of studies for research purposes. However, the new rule will shorten the wait for organs for all – irrespective of health status.
It will increase the pool of available organs.
“This rule removes unnecessary barriers to kidney and liver transplants, expanding the organ donor pool and improving outcomes for transplant recipients with HIV," US Health and Human Services Secretary Xavier Becerra said in a statement.
HIV organ transplant is completely safe
According to a study published in the New England Journal of Medicine, the practice would be totally safe. For the study, nearly 200 organ recipients were followed for four years, comparing those who received kidneys from HIV-positive donors to those whose kidneys came from donors without HIV.
Both groups had similarly high rates of overall survival and low rates of organ rejection.
According to experts, the rule builds on the federal government's promise to advance health equity and reduce barriers to care for people with HIV. By increasing the pool of available organs and streamlining the transplantation process, the policy is expected to not just save lives but also reduce stigma and discrimination associated with HIV, and lower costs and wait times.
The rule, which specifically applies to kidney and liver transplants, shows the power of biomedical evidence to inform policy. The HOPE Act expansion was driven by a large body of evidence, much of which was funded by the National Institutes of Health (NIH) and HHS, which demonstrates the noninferiority of kidney transplants between donors and recipients with HIV compared to transplants from donors without HIV to recipients with HIV.
Previously conducted studies showed HIV-positive donor organs were safe
In 2010, surgeons in South Africa provided the first evidence that using HIV-positive donor organs was safe in people with HIV. But the practice wasn’t allowed in the United States until 2013 when the government lifted a ban and allowed research studies.
At first, the studies were with deceased donors. Then in 2019, a team at Johns Hopkins University in Baltimore performed the world’s first kidney transplant from a living donor with HIV to an HIV-positive recipient.
All told, 500 transplants of kidneys and livers from HIV-positive donors have been done in the US.
HIV donor organ plant to be expanded
The National Institutes of Health has now published a notice seeking public comment on a proposed revision to its research criteria for transplant of other organs like the heart, lung, and pancreas.
According to doctors, the effort would streamline requirements and continue to build evidence-based data on outcomes of organs other than livers and kidneys.
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