HIV+ organ transplants?
2009-09-28 09:30
Alicestine October
Cape Town - The organs of deceased HIV-positive people are becoming increasingly sought-after, due to South Africa's severe organ shortage.
A new clinical protocol has been tested at Groote Schuur hospital since last year. The goal is to determine how HIV-positive people with end-phase kidney failure react to kidneys transplanted from deceased HIV-positive patients.
The South African Transplantation Society's congress, held at Spier outside Stellenbosch at the weekend, included a presentation on the matter.
"There is a severe shortage of kidneys," said the Society's Dr Elmien Steyn.
Same right to organs
Steyn explained that South Africa has many HIV-positive people, but they are not always suitable candidates for dialysis, and many are turned down for the treatment. Steyn feels strongly that HIV-positive people have the same right to organs as other people.
"If we have an HIV-positive donor with kidneys that won't be suitable for anyone else anyway, why not use them? That's how the project began."
Steyn said HIV-positive people often aren't seen as potential organ donors. However, she said there are still several problematic issues, such as the impact of various HIV subtypes and the possibility of rejection.
"But then again: Does it matter? The potential recipient wouldn't have survived anyway with end-phase kidney failure. It's still a win-win situation."
However, some issues with regard to infections in HIV-positive transplant recipients have yet be addressed.
According to Steyn, four such transplants have been performed on HIV-positive patients as part of the protocol testing.
"Thus far the patients' progress has been very good," she said.
Challenges
South Africa faces many challenges regarding organ transplants.
"Surveys showed that most medical students have no idea what organ transplants are all about. Ignorance among patients and healthcare workers is also a problem. We'll have to invest more in education and awareness," she added.
A kidney transplant expert at Cape Town's Christiaan Barnard Memorial hospital, Dr Julian Jacobs, said the possibility of training at least one healthcare worker at every healthcare institution across the country in proactive organ donor recruitment is being considered.
"This would imply that dying patients should always be seen as possible sources of life. One of the most important things families need to be made aware of, is that death is not the end."
According to Jacobs there are approximately 4 000 patients countrywide on a waiting list for organs, and South Africa performs on average 400 transplants per year.
- Die Burger