This Week in Medicine

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While you may have spent your February 14th with chocolates and flowers, the Emory Transplant Center was celebrating a different kind of holiday, National Organ Donor Day, in an especially unique way. Though no hearts were exchanged, a kidney was, and this time between HIV positive individuals. Emory is one of nine medical centers nationwide to pilot the HOPE in Action clinical trial, and just last week performed its first kidney transplant from a deceased HIV-positive donor to an HIV-positive recipient with end-stage kidney disease. This is the first to be performed in the country in 2017, and the first of its kind to ever be performed in the state of Georgia. Before 2013, it was illegal for HIV-positive individuals to donate their organs, due to fears of spreading the disease at a time when it was not yet well-understood. However, after the passing of the HIV Organ Policy Equity (HOPE) Act, these laws were amended to allow HIV-positive to HIV-positive organ donation. This marked a major advance in improving health outcomes among HIV populations, as many remain for months or years on waiting lists for organ transplants. The HOPE Act is meant to reduce the amount of time these patients have to wait for a transplant match, as it significantly widens the donor pool. Original estimates cited by the U.S. government indicate that upwards of 600 additional donations each year could occur between HIV-positive individuals. This is particularly impactful since demand has increased as improvements in antiretroviral drugs and medications for HIV management have worked to extend life expectancies for those with the disease, leading to more individuals placed on the organ transplant waiting list. Currently around 10,000 HIV-positive individuals remain on dialysis awaiting kidney transplant. Since the HOPE Act was first fully enacted in 2016, twenty patients around the country have received HIV-positive donated organs as a part of the HOPE in Action clinical trial. The goal of this trial is to study safety and effectiveness guidelines of these kinds of transplants, and in the future ensure the best possible health outcomes for the patients. With the help of Dr. Nicole Turgeon and other members of the Transplant Division, Emory is well on its way to making an impact in the HIV community.

Sources

Boyarsky BJ, Hall EC, Singer AL, Montgomery RA, Gebo KA, Segev DL. Estimating the Potential Pool of HIV-infected Deceased Organ Donors in the United States. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 2011;11(6):1209-1217. doi:10.1111/j.1600-6143.2011.03506.x.

Christenbury, J. (2017, February 14). Emory Transplant Center performs its first HIV-positive kidney transplant from HIV-positive deceased donor. Retrieved February 20, 2017, from http://news.emory.edu/stories/2017/02/euh_first_hiv_to_hiv_kidney_transplant/index.html

Kasperowicz, P. (2016, February 02). Congress opens door to allowing HIV organ donations. Retrieved February 20, 2017, from http://thehill.com/blogs/floor-action/healthcare/189820-congress-opens-door-to-allowing-hiv-organ-donations

Miller, K. A. (2016, September). HIV & Organ Transplants: Facts, Stigma and the HOPE Act. In HIV Medicine Association. Retrieved February 20, 2017, from http://www.hivma.org/uploadedFiles/HIVMA/News_Announcements/HOPE%20Act%20USCA%202016%20Miller%20with%20Cover%20Slide.pdf#search=%22HOPE%20act%22

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