Organ transpalnt and renal failure. It is known that anti-retroviral treatments are allowing AIDS patients to become long-term chronically-ill patients. This means that many of them may suffer concomitant diseases throughout their lifetime. One such condition that often occurs in these individuals is renal failure, which sometimes requires long-term dialysis treatment, while awaiting a possible kidney transplant.
However, one problem that arises is whether it is ethically acceptable to use donor organs for patients whose life expectancy is uncertain, since there is a long waiting list in almost every country for HIV-negative people who require transplant of some organ, which is thought could be medically and socially more cost effective.
Now however, Elmi Muller, a surgeon in Cape Town in South Africa, has proposed using organs donated by HIV-positive patients. This donor group in South Africa could be large, given the high prevalence of AIDS patients in the country.
Thus, in 2008, Muller performed the first renal transplant from a HIV-positive donor on a patient from a list of 29 AIDS patients. There are currently 55 more people on the waiting list.
The initial results seem promising, since after the appropriate immunosuppressant therapy, only three patients have rejected the transplanted organ.
In 2010, Elmi Muller’s team published the first results of this innovative practice, showing that their first four patients had survived the transplant with no complications for two years.
Without doubt, in view of the lack of organs for transplant (there are more than 1000 patients awaiting kidney transplant in the United States alone), Muller’s proposal could be a solution for AIDS patients who require renal transplant, thus overcoming the ethical problems that could arise if healthy donors are used for these types of patients (Nature Medicine 20; 1086-1088, 2014).