April 4, 2004
WHY NOT JUST BURN MONEY?:
HIV organs for HIV patients (JIM RITTER, April 4, 2004, Chicago Sun-Times)
Doctors at Northwestern Memorial Hospital and Northwestern medical school have proposed what they describe as a "bold and innovative" new way to increase the supply of transplant organs -- giving HIV-infected organs to HIV patients.It's now illegal to transplant an organ from anyone who has HIV because the virus could infect the recipient.
The law makes it difficult for patients such as George Martinez, who's been waiting 14 months for a liver transplant. Martinez would be happy to get a liver from an HIV-positive donor. He's not worried about getting HIV because he already has it.
Martinez's doctors at Northwestern back a bill that would make Illinois the only state to allow transplants from HIV-positive donors, provided that the recipients also have HIV. The bill recently passed the Illinois House on a 95-22 vote and is pending in the Senate.
As a general principle it's a bad idea to use extraordinary methods for folks whose diseases are volitional--as giving Mickey Mantle a new liver--but a system of transplants for the immuno-suppressed seems likely to prove problematic. Posted by Orrin Judd at April 4, 2004 10:20 AM
Well, it depends on the definition of "volitional." My best friend died of AIDS, and he caught it before it was even a known disease. Hard to say that was volitional except in the loosest possible sense of the term, like saying dying in a car crash is volitional because car travel has risks. Anybody literate who's gotten infected in the last 15 years or so, though, is a fool.
And hey, it's not like anybody else wants an HIV-infected liver.
Posted by: PapayaSF at April 4, 2004 4:10 PMThis is a horrible idea. Presumably, if someone has died of HIV, they're going to be more overrun with the virus than someone who has not. So transplanting their organs is hardly going to help anyone's lifespan at all, and has the possibility of even shortening it. Add to this fact that HIV-infected organs are going to have many other problems, and the whole thing just sounds absurd. And if they take enough precautions to make it even slightly less absurd, they'll hardly have any organs to use.
As with much of the furor surrounding HIV, it's indicative of the gay lobby's disproportionate power that this is even being considered.
Posted by: Timothy at April 4, 2004 5:49 PMTimothy, the guy's liver is probably failing not because it is HIV-infected, but because of the side effects of the anti-HIV drugs he's taken. So a new liver, even an HIV-infected one, might well allow him to live longer, though whether it'd be weeks or years, I have no idea.
Posted by: PapayaSF at April 4, 2004 6:10 PMThe ABA is licking its chops on this one.
Posted by: Peter B at April 4, 2004 7:06 PMBut adding more HIV to the mix is going to speed that process, especially because the new HIV is likely to be a slightly different strain. That's going to counteract any additional time added from the new liver.
Posted by: Timothy at April 4, 2004 8:51 PMregarding viral load and its effect on organs, each person/organ will be different. suffice it to say, those things with high vascularity (liver, kidneys) are likely to be worse off than others (cornea, eustachian tube, etc). unfortunately, those organs in highest demand have highest vascularity. not to mention the inherent problem of transplanting a person with immunosuppression, who will then require more immunosuppression to prevent GVH or graft failure.
it's a stupid idea as just the CMV infection rate alone would likely lead to quicker death in these patients.
Posted by: a at April 5, 2004 1:00 PMOn the other hand, if they're already immunosuppressed, why not a little more?
Although I wonder if this will result in cross-mixing of AIDS strains...
Posted by: mike earl at April 5, 2004 2:33 PM