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WASHINGTON – Baltimore surgeons have made it believed to be the world's first kidney transplant from a living donor living with HIV, a milestone for AIDS patients who need a new organ. If other donors living with HIV came forward, this could free up space on the waiting list for transplants for everyone.
Nina Martinez of Atlanta went to Johns Hopkins University to donate a kidney to an HIV-positive stranger, saying that she "wanted to make a difference in someone else's life." And to combat the stigma that still surrounds HIV infection too often.
Many people think that "someone with HIV is supposed to look sick," said Martinez, 35, at the Associated Press before Monday's operation. "It's a powerful statement that to show someone like me a person in good health to be a living organ donor."
Hopkins, who will release the transplant on Thursday, said Martinez and the receiver of his kidney, who had chosen to remain anonymous, were recovering well.
"This is an illness that in the past was a death sentence and is now so well controlled that it offers people with this disease the opportunity to save someone who is sick." "Other," said Dr. Dorry Segev, a Hopkins surgeon who advocated for HIV policy. The law on equity, or HOPE, lifted the US ban on 25-year transplants between HIV-positive people.
The number of HIV-positive patients among the 113,000 people on the country's waiting list for an organ transplant is not counted. HIV-positive patients can receive transplants from HIV-negative donors, just like everyone else.
It is only in recent years, encouraged by pioneering operations in South Africa, that doctors have begun to transplant organs from deceased HIV-infected donors to patients with the virus, organs that would have been thrown away.
Since 2016, 116 such kidney and liver transplants have been performed in the United States as part of a research study, according to the Unified Organ Sharing Network (UNOS), which oversees the transplant system. One of the questions is whether receiving an organ from a person living with a different strain of HIV presents risks, but up to now, there has been no problem of safety, said Dr. David Klbaden, chief medical officer of UNOS.
Hopkins' Segev said Monday's kidney transplant was a world first. Doctors have been reluctant to allow people who are still living with HIV to make a donation, fearing that their remaining kidney will be damaged by the virus or by older drugs used to treat it.
But new anti-HIV drugs are safer and more effective, Segev said. His team recently researched the kidney health of 40,000 HIV-positive people and concluded that people whose HIV was well controlled and did not suffer from any other harmful kidney condition like high blood pressure should face the same risks than a living donor than people who are not infected with HIV.
"There are currently tens of thousands of people living with HIV who could be living donors for the kidney," said Segev, who advised other hospitals considering this approach.
As a rule, live donor kidneys last longer, added Dr. Niraj Desai, a Hopkins surgeon who looks after the recipient. And if more people living with HIV eventually donate, it will help more than HIV-positive patients who need a kidney.
"It's a lesser person waiting for a limited resource," Desai said. "It helps everyone on the list."
Martinez, a public health consultant, is interested in living donation, even before the start of HIV transplants. Then last summer, she learned that an HIV-positive friend needed a transplant and found Segev to ask if she could donate.
Her friend died before Martinez pbaded the required health tests, but she decided to honor him by donating to someone she did not know.
A runner planning to participate in the Marine Corps marathon in the fall: "I knew I was probably as healthy as someone who was not living with HIV and was badessed as a kidney donor," said Martinez. "I've never been so sure of anything."
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The Associated Press Science & Science Department is supported by the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.
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