Antiretroviral therapy has reduced the impact of HIV infection in the past twenty years, yet the HIV-positive community still faces major health challenges.
“Because of advancement in HIV therapy, HIV patients are living longer,” says Maricar Malinis, M.D., medical director of the Transplant Infectious Disease section at the Yale School of Medicine. Today, HIV patients are more likely to die of chronic medical conditions rather than HIV related infections. Kidney disease is increasingly more common, and can progress more rapidly in HIV positive patients compared to non-HIV patients. These patients are therefore in increasing need of organ transplantation.
“Unfortunately, there is a limited donor pool,” Malinis says. According to data from the United Network for Organ Sharing, more than 120,000 individuals are waiting for organ transplant, and about 10,000 donors are available per year. “Waiting time for a kidney in certain regions of the U.S. can be more than ten years.”
At Yale, this is about to change: Yale is set to participate in a new study that has the potential for a major breakthrough in HIV treatment: the transplant of organs between HIV positive patients. The HIV Positive Organ Policy Equity (HOPE) Act, signed into law by President Obama in 2013, removes the ban on these transplants in the clinical research setting.
The HOPE Act allows participating centers to conduct liver and kidney transplants between HIV-positive donors and recipients. The New England Donor Bank estimates that 1,000 HIV-positive patients could be saved each year through liver and kidney transplants from HIV-positive donors.
Yale played a role in one of the first transplants to occur under the HOPE Act. In March, the kidneys and liver of a donor who was a Yale patient were transplanted into two HIV-positive patients at Johns Hopkins Hospital in Baltimore. Both transplants were the first of their kind in the United States.
Malinis is the primary investigator of the HOPE Act study at Yale, which will conduct kidney transplants only. “The use of HIV positive donors has the potential to expand the donor pool and decrease the wait list time for both HIV positive and HIV negative transplant candidates,” she says.
The study will begin enrolling patients on September 1. For more information, contact Ricarda Tomlin (203-785-2073) or email@example.com.