The Cleveland Clinic has successfully transplanted a kidney from a donor with HIV, the human immunodeficiency virus, to an HIV-positive recipient in one of the first such transplants in Ohio.
The transplant would have been unthinkable to doctors in the 1990s, due to the stigma around the disease, said Dr. Alvin Wee, the program director for kidney transplantation at the Cleveland Clinic.
Thanks to medication available to treat HIV and other advances these transplants are now possible.
“All the things that in the past that we used to say no, is a possibility now,” said Wee.
The recipient of the kidney is a 35-year-old Cleveland man, who experienced kidney failure from diabetes, and who has been on the national transplant list since 2020.
The man has recovered well from the procedure, is working full time and enjoying daily activities as he did before his kidney failure, said Wee.
“He’s very happy. If you talk to him, he's back to his usual self,” he said.
The recipient got a kidney from an out-of-state HIV-positive donor within two years of joining the HIV-positive donor list. Normally, the average wait is three to seven years for a kidney, Wee said. The timing likely saved the man’s life since being on dialysis for an extended period can be dangerous for young people.
Wee said some HIV-positive patients are anxious about the idea of receiving an organ from an HIV-positive donor, but he said when they learn about the procedure, the fears go away.
“Hopefully with this, we all should be able to help more people who are HIV positive, showing them that this is a possibility,” he said. “[We] are not here to judge, we're here to help them.”
In 1988, the U.S. Congress banned anyone with HIV from donating an organ, out of concern about spreading the disease.
The ban was reversed in 2013 with the HIV Organ Policy Equity Act (HOPE Act) when a growing number of physicians realized HIV-positive donors were being needlessly excluded from donating to HIV-positive recipients.
But even today, less than 10% of the 280 or so transplant centers in the U.S. will transplant an organ from an HIV-positive donor because of the challenges with getting facilities certified, Wee said.
People in need of a new kidney who are HIV positive can enter a separate list to wait for a donated kidney from an HIV-positive donor. Wee said that shortens the national list for people without HIV, who will now have faster access to a kidney, due to more kidneys being available for transplantation.
To Wee the ability to offer transplants to people with HIV is worth it, even if it helps a small number of those looking for a kidney.
“The imbalance between people who need an organ and the organ availability only increases as time progresses,” he said. “Even though we have done a record number of [transplants] in 2021, in the whole United States, [we’ve] got more people on the list that we need to be transplanting.”
