GESTIÓN EN SALUD PÚBLICA: Surgeons perform first kidney transplant from living HIV-positive donor

martes, 2 de abril de 2019

Surgeons perform first kidney transplant from living HIV-positive donor

Surgeons perform first kidney transplant from living HIV-positive donor

Bioedge

Surgeons perform first kidney transplant from living HIV-positive donor

by Xavier Symons | 30 Mar 2019 | 1 comment

A team of surgeons at Johns Hopkins University Hospital have transplanted a kidney from a living HIV-positive donor to a HIV-positive recipient in a groundbreaking procedure. Doctors hope that it will expand the pool of available organs and help change perceptions about HIV.

The transplant operation took place on Monday and involved donor 35-year-old Nina Martinez from Atlanta and an anonymous recipient. The operation was a success and both Martinez and the recipient are making a good recovery, doctors said. The recipient does not need dialysis for the first time in a year.

Acquiring organs from those known or suspected to be HIV-positive was banned in the US at the height of the AIDS epidemic and only became legal again in 2013. Ethicists have been advocating for more equitable organ allocation legislation for decades.

“This is the first time someone living with HIV has been allowed to donate a kidney, ever, in the world, and that’s huge,” Dr. Dorry Segev, a professor of surgery at the Johns Hopkins University School of Medicine, said in a statement Thursday. “A disease that was a death sentence in the 1980s has become one so well-controlled that those living with HIV can now save lives with kidney donation — that’s incredible.”

Recent research conducted by Segev and his colleagues on over 40,000 HIV-positive individuals showed that the new antiretroviral drugs, which suppress the AIDS-causing virus, are safe for the kidney, and that people living with well-controlled HIV are healthy enough to donate kidneys and face basically the same risks as those who don't have HIV.

It is hoped that the operation will help decrease stigma of patients living with HIV.

“Some people believe that people living with HIV are ‘sick,’ or look unwell,” Martinez told reporters. “I want people to change what they believe they know about HIV. I don’t want to be anyone’s hero. I want to be someone’s example, someone’s reason to consider donating.”

More than 113,000 people are on the US waiting list for organ transplants, most of them seeking kidneys. HIV-positive individuals with organ failure face disproportionately higher mortality while awaiting an organ transplant. It is hoped that the availability of HIV-positive organs from both deceased and living donors will help save the lives of HIV patients on the waiting list.

Xavier Symons is Deputy Editor of BioEdge

With hate crimes like the recent murders of 50 Muslims in Christchurch, New Zealand, by a white nationalist, some bioethicists are asking whether bigotry is a disease. And, if so, whether it can be prevented (or cured) with the tools in the armoury of public health professionals. In an article below, public health experts suggest four ways that doctors can push back against hatred.

It's an interesting line of thought. Clearly some forms of bigotry and hatred lead to deadly crimes. But defining hatred is often deeply political. The members of the KKK and ISIS are clearly dangerous "haters". But how about foes of Muslim immigration or same-sex marriage? Are they "haters" or just political opponents? I must confess that I feel that the bioethics of hatred is off to a shaky start, conceptually. But I believe that it will become more prominent as time goes on. The Christchurch gunman let a genie out of the bottle.