HOPE Act Allows HIV-Positive to Donate Organs

AIDS service organizations are applauding the House of Representatives' recent decision to allow people living with HIV to donate their organs to other people living with HIV. The passage of the HIV Organ Policy Equity (HOPE) Act, which is awaiting President Barack Obama's signature, could save the lives of more than 1,000 PLWHAs with liver and kidney failure each year.

"Since the ban was implemented in 1988, the development of Highly Active Antiretroviral Therapy (HAART) has significantly improved the life expectancy of people living with HIV," said Jason Cianciotto, GMHC's Director of Public Policy. "As a result, the population living with HIV in need of organ transplantation has grown significantly. The HOPE Act is a critical step toward ensuring that people living with HIV can give and receive the gift of life. [It] is not only a scientifically sound public health policy, but also a great act of compassion."

The HOPE Act would allow donated, HIV-positive organs to be used for transplants to other HIV-positive patients. For the past 25 years, federal law has prohibited this medical procedure. But the HOPE Act will now direct the Department of Health and Human Services and the Organ Procurement Transplant Network (OPTN) to develop standards for research on HIV-positive organs, and permits pos-to-pos transplants if research determines this is warranted. This research is expected to take about a year, according to Johns Hopkins University transplant surgeon Dorry Segev.

"Thanks to the HIV Medicine Association (HIVMA) and many other advocates for their tireless work in leading the passage of the HOPE Act though Congress. Lifting the ban will save many lives and reduce health care costs," said Chris Collins, amfAR's Vice President and Director of Public Policy.

OPTN must develop standards to ensure that these transplants do not impact the safety of the organ transplantation network. The legislation also amends federal criminal law regarding HIV transmission to clarify that these organ donations are not barred.

There are also some concerns about "superinfecting" another HIV-positive patient with a second strain of the virus through such a transplant. More research will be needed to determine how immune-boosting ARVs will interact with the transplant drugs that prevent rejection of donor organs. Some research has suggested that PLWHAs are more likely to reject organ transplants.

In addition to saving the lives of hundreds of PLWHAs, the HOPE Act will also make more organs available for transplant. There are currently more than 100,000 patients waiting for life-saving healthy organs, with 50,000 more added each year. Allowing PLWHAs to donate organs to other PLWHAs will take an estimated 600 of these patients off the list, shortening the general waiting list for uninfected people.

"By reforming outdated policies banning all HIV-positive organ donations, Congress has provided hope not only to the thousands of people living with HIV in desperate need of a transplant, but also HIV-negative individuals who will benefit from the decrease in demand for uninfected organs," said National Minority AIDS Council (NMAC) Director of Legislative and Public Affairs Kali Lindsey.

Passage of the HOPE Act will save lives and help break down the stigma associated with HIV/AIDS, said amfAR's CEO Kevin Frost, adding that, "This legislation makes federal organ donation regulations more reflective of the evidence and allows for critically important research to move forward."

Senators Barbara Boxer, Tammy Baldwin, Tom Coburn and Rand Paul introduced the legislation in the Senate, with Rep. Lois Capps introducing it in the House. It passed unanimously in the Senate and House Committee on Energy and Commerce this summer, and on Nov. 12, it passed in the House, also by unanimous consent. It now awaits signature by the President.

"NMAC applauds Congress for taking action on this important piece of legislation," added Lindsey. "In particular, we thank Senators Barbara Boxer and Tom Coburn, as well as Representatives Michael Burgess, Lois Capps and Andy Harris, whose bipartisan leadership was critical to the law's passage. Their efforts are a sign that Republicans and Democrats can still work together for the good of our nation and its citizens."