Senate Approves Bill to Allow HIV+ Patients to Receive HIV+ Donor Organs

The U.S. Senate this week unanimously passed the HOPE Act, a bill that will make an exception to current law enabling people with HIV to receive organs for transplantation from another HIV positive individual. The measure now awaits approval from the House of Representatives.

The HOPE, or HIV Organ Policy Equity, Act was sponsored by a bipartisan coalition including Sens. Barbara Boxer (D-CA), Coburn (R-OK), Tammy Baldwin (D-WI), and Rand Paul (R-KY).

"I applaud the Senate for moving to end this outdated ban on research into organ donations between HIV-positive individuals," Boxer said. "This legislation offers hope for thousands of patients who are waiting for transplants by allowing scientists to research safe and effective ways to transplant these organs and save lives."

"The passage of the HOPE Act is an encouraging step forward for HIV-positive individuals who need organ transplants," Coburn, himself a physician, added. "Bylifting these arcane federal regulations, we give hope by allowing doctors and scientists to explore potentially transformative research into organ donations between HIV-positive patients."

The bill overturns anamendment to the National Organ Transplant Act instituted in the late 1980s -- when less was known about the science of HIV transmission and people with HIV were mostly too ill to undergo transplantation -- than bans use of, or even research on, donor organs from HIV positive individuals.

Since that time, studies -- mostly looking at kidney and liver transplants -- have shown that people who are on effective antiretroviral therapy and have well-controlled HIV and relatively high CD4 T-cell counts can achieve outcomes similar to those of HIV negative transplant recipients. The need for liver transplants is particular pressing among people with HIV and hepatitis B or C coinfection.

The HOPE Act directs the Secretary of Health and Human Services to monitor medical research to determine if HIV positive-to-positive transplants are safe, and if so, to instruct the Organ Procurement and Transplantation Network to establish appropriate procedures. 

By reducing the number -- albeit small -- of HIV positive people on transplant waiting lists, the bill could potentially also help some HIV negative recipients receive organs sooner. A recent study in the American Journal of Transplantation estimated that allowing transplants from HIV positive donors to HIV positive recipients could increase the donor pool by 500-600 per year. 

"As HIV clinicians, researchers, and other health care professionals on the frontlines of the HIV/AIDS pandemic, we applaud the U.S. Senate for unanimously passing bipartisan legislation yesterday that would allow research on organ donation from deceased HIV-infected donors to HIV-infected recipients," said HIV Medicine Association chair Michael Horberg in a media statement.

"The HOPE Act would update outdated federal law to reflect the current medical understanding of HIV/AIDS and allow for the scientific research needed to fully evaluate HIV-infected organ donation to HIV-infected patients," he continued. "For patients living with HIV, deceased donors who are also HIV infected may represent a unique source of organs that could save the lives of hundreds of HIV-infected patients with liver and kidney failure each year."

6/19/13

Sources

Michael Horberg, HIV Medicine Association. HIV Experts Applaud Senate Passage of HOPE Act, Call for House to Take Action. Media statement. June 18, 2013.

Sen. Barbara Boxer. Boxer, Coburn Praise Senate Passage of the HOPE Act. Press release. June 18, 2013.

Human Rights Campaign. Senate Passes HIV Organ Policy Equity Act. HRC Blog. June 18, 2013.