Transplants from AIDS patients in world first
Source: Agencies |
June 18, 2010, Friday
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SOUTH African surgeons have transplanted kidneys between donors and patients who were both infected with the AIDS virus - a medical first that has some doctors buzzing about whether it could be tried in the United States.
The first four of the transplants, which took place in 2008, are described in the current New England Journal of Medicine.
Five more have been done since then at the same Cape Town hospital, Groote Schuur. It's the only medical center in the world to have done them, said one of the transplant surgeons, Dr Elmi Muller.
The US bans transplants from HIV-infected donors out of fear they will spread the AIDS virus to recipients. Some have occurred by accident, however, when a donor's infection was not detected beforehand.
Muller was in the US last week and discussed the work at a National Institutes of Health meeting.
"We've been talking a lot about whether it makes sense to start doing this," said Dr Peter Stock, a researcher at the University of California, San Francisco.
HIV patients can survive decades with the help of medication. Now, many of them also struggle with kidney disease, which in some cases is a complication of their infection, and need dialysis.
But HIV patients suffer anemia more than other dialysis patients and face additional risks. The waiting list for a kidney is currently eight years in the US. Allowing HIV-infected patients to donate organs might allow some patients with HIV to receive organs faster, Stock said.
US doctors already transplant organs between donors and patients with hepatitis C, he added.
The early successes in Cape Town may be difficult to translate to America. Drug-resistant strains of HIV are more common in the US. Doctors fear that an organ recipient with HIV will become infected with a strain more drug resistant - and dangerous - than the one they already have.
South Africa has an estimated 5.7 million people with HIV, more than any other country. Muller said dialysis for HIV patients is extremely limited, leaving them in desperate need of a transplant.
The first four of the transplants, which took place in 2008, are described in the current New England Journal of Medicine.
Five more have been done since then at the same Cape Town hospital, Groote Schuur. It's the only medical center in the world to have done them, said one of the transplant surgeons, Dr Elmi Muller.
The US bans transplants from HIV-infected donors out of fear they will spread the AIDS virus to recipients. Some have occurred by accident, however, when a donor's infection was not detected beforehand.
Muller was in the US last week and discussed the work at a National Institutes of Health meeting.
"We've been talking a lot about whether it makes sense to start doing this," said Dr Peter Stock, a researcher at the University of California, San Francisco.
HIV patients can survive decades with the help of medication. Now, many of them also struggle with kidney disease, which in some cases is a complication of their infection, and need dialysis.
But HIV patients suffer anemia more than other dialysis patients and face additional risks. The waiting list for a kidney is currently eight years in the US. Allowing HIV-infected patients to donate organs might allow some patients with HIV to receive organs faster, Stock said.
US doctors already transplant organs between donors and patients with hepatitis C, he added.
The early successes in Cape Town may be difficult to translate to America. Drug-resistant strains of HIV are more common in the US. Doctors fear that an organ recipient with HIV will become infected with a strain more drug resistant - and dangerous - than the one they already have.
South Africa has an estimated 5.7 million people with HIV, more than any other country. Muller said dialysis for HIV patients is extremely limited, leaving them in desperate need of a transplant.
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