'Explore HIV+ transplants'

2008-03-17 16:18

Cape Town - Research is needed on the possibility of giving HIV-positive kidney patients transplants from HIV-positive donors, according to a group of medical experts.

The group, which include academics working in the fields of Aids and ethics, and a transplant surgeon, make the call in an article in the latest issue of the SA Medical Journal.

They say currently the use of donor organs from dead people is limited by the fact that so many of those people - over a quarter in one recent study - are HIV positive.

"Could HIV-positive kidneys be transplanted into HIV-positive recipients?" they ask.

"The idea is enticing - a significant number of patients could receive transplants, and donor kidney supply could be maximised."

They caution, however, that there is a possibility of transmitting to recipients different strains of HIV, drug-resistant viruses, or opportunistic infections such as tuberculosis.

In addition, donated HIV positive kidneys might not be as robust as ones free of the disease.

They say there are a host of ethical questions around such transplants, including the fact that patients would be exposed to unknown medical risks.

However, they say, health care to HIV positive patients has in the main taken backstage in South Africa, and they have suffered discrimination and stigmatisation.

"Justice may require a remediation of these past injustices by according new opportunities to this group that has been so unfairly treated," the experts say.

"Research is needed, and probably a good starting point would be to ask potential HIV-positive transplant recipients whether they would accept an HIV-infected kidney with the unknown level of risk described above."

- SAPA