On November 21, United States President Barack Obama signed a bill reversing the ban preventing people with human immunodeficiency virus (HIV) from donating their organs after death. This coup comes two years after a paper was published estimating that some 500 people with HIV would be eligible for organ donation if not for the ban, enabling hundreds of life-saving transplants for patients also infected with the virus.
Removing the ban doesn’t simply help those with HIV: by reducing the number of people on organ transplant lists, all patients benefit. According to ABC News, there are currently 120,000 people on the waiting list for organ transplants.
The ban has been in place for 25 years as part of the National Organ Transplant Act of 1984, which banned the sale of human tissues, and which was amended in 1988 to prohibit organs from HIV-infected persons for transplants. This amendment was passed at a time when we had very little understanding of HIV and concerns about transmission made it logical to impose such a limitation. The ban, unfortunately, also effectively outlawed research into such transplants.
These two decades since have brought better understanding of HIV, but the law remained in place without reprieve. As Andrew Cray pointed out in a piece supporting the HIV Organ Policy Equity (HOPE) Act earlier this year:
… the effect of the law now is that it prohibits the acquisition of organs from HIV-positive donors, while hundreds of HIV-positive people in need of donated organs languish on long transplant waitlists. Unfortunately, these organ-donation restrictions have endured despite significant advances in testing, screening, and transmission prevention; are vestiges of antiquated bias and misinformation; and no longer align with the progress made in medical technology and public health policy. The lack of medical rationale for this ban is underscored by the fact that current policies regarding HIV are significantly more restrictive than policies addressing other infections that can also be transmitted during the transplantation process. Individuals who test positive for hepatitis C, for example, are permitted to donate organs to patients who also have hepatitis C.
It’s a wonderful thing to see these changes being made. Until now, only South Africa allowed such transplants.
“For many years, we have been forced to forego perfectly transplantable organs. Now we can give patients with HIV the opportunity to live longer and better lives by transplanting these organs. It will be a profound change,” said Johns Hopkins transplant surgeon Dorry Segev, one of the authors of the paper that put the situation in perspective.
The HOPE Act was a bipartisan effort drafted by Representative Lois Capps (a Democrat from California and registered nurse), Senator Barbara Boxer (also a Democrat from California) and Senator Tom Coburn (a Republican from Oklahoma and a medical doctor).
Header image by James Mutter.