Yale New Haven Hospital has been given the go signal by the United Network for Organ Sharing to do HIV-HIV organ transplants. It is now one of eight transplant centers in the United States allowed to use organs from HIV-positive donors and the only one in New England to receive the approval.
In March, a team from Johns Hopkins Medicine performed the first-ever HIV-HIV liver and kidney transplants in the United States at YNNH.
According to YNNH Transplant Infectious Diseases medical director Dr. Maricar Malinis, those with HIV are living longer now because anti-retroviral treatments are working. However, this means they are also likelier to develop chronic medical conditions much like non-HIV patients, which can result in a need for an organ transplant.
For instance, end-stage renal disease is becoming a big threat to the HIV population, giving rise to a growing need for kidney transplantations. With organs from a deceased HIV patient, those who also have the disease don't have to wait as long to undergo the transplant they need. This also frees up organs for patients on the transplant list who don't have HIV.
Previously, transplant doctors were prevented from using organs from HIV patients, even if it is to save another HIV patient. HIV-HIV transplants had been shown to be successful in South Africa, but it wasn't until the HIV Organ Policy Equity (HOPE) Act was passed in 2013 that the practice became feasible in the United States.
"The shortage of donated organs is very real for our patients ... We are proud and excited that the Yale New Haven Transplant Center is able to be part of the vanguard leading the push to increase opportunities for transplantation for all of our patients," said Dr. Peter Yoo, YNNH Surgical Residency director.
According to him, YNNH will be enrolling its first patients for the HIV-HIV transplant program starting September. The program will be led by Malinis, Yoo and Dr. Richard N. Formica, Jr., Transplant Medicine director.
In 2015, 218 patients with HIV underwent kidney transplants, based on data from UNOS. In the same year, a total of 17,878 kidney transplants were carried out in the United States. However, more than 4,200 patients died while waiting for their turn on the transplant list.
Recently, researchers led by a team from the Children's Hospital Los Angeles' Saban Research Institute were able to generate a functional human liver from progenitor and adult stem cells. According to the study published in the journal Stem Cells Translational Medicine, the generated liver featured the usual structural components like bile ducts, blood vessels and proliferative liver cells called hepatocytes.