Furthermore, the risks
following donation will be the same for those without HIV and those with it.
on the success of the transplant, Dr.
Segev said, "This is the first time
someone living with HIV has been allowed to donate a kidney, ever, in the
world, and that's huge."
added, "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."
Why is this Transplant
Christine Durand, Associate Professor of Medicine and Oncology and member of
the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center said, "What's meaningful about the first living
kidney donor--who is also living with HIV--is that this advances medicine while
defeating stigma, too. It challenges providers and the public to see HIV
Speaking about the impact of the transplant, she mentioned, "As patients waiting for a transplant see
that we're working with as many donors as possible to save as many lives as
possible, we're giving them hope. Every successful transplant shortens the
waitlist for all patients, no matter their HIV status."
HOPE in Action
Durand and Dr. Segev are leading an initiative called HOPE in Action
which brings together numerous national studies investigating the feasibility,
safety and effectiveness of HIV-to-HIV transplantation. This initiative came
into being following Dr. Segev's work and advocacy for the 2013 federal HIV Organ Policy Equity Act (the HOPE Act).
2016, Dr. Durand and Dr. Segev had led the team
that performed first deceased donor HOPE transplants in the US. Following this, they are now leading two NIH-funded trials of HIV-to-HIV kidney and
liver transplants. This first-ever living kidney donor transplant is
a major landmark for HOPE.
The Donor's Experience "Don't call me a hero,
call me the first. I want to see who comes next,"
says Nina Martinez, the 35-year-old kidney donor living with HIV. She first
came to know about the HOPE Act in 2013 when it was passed. She did not realize
that this would affect her personally until she watched the medical drama
Grey's Anatomy a few months later. The writers of the TV drama had created a storyline
about the first living kidney donor with HIV which allowed Martinez to think
about a possibility in her future. "I was
also inspired by a friend and neighbor who herself became a living kidney
being a part of HOPE for Action's research, she said, "Participating in clinical research is, for me, extremely important. I
bore witness to my friend providing a lifesaving transplant, and in watching
her I knew that if there was a way for me to help someone else, I had to do it.
Doing so under a research protocol was very comfortable for me."
Life Beyond HIV -
Nina's Journey to Donation Nina
a resident of Atlanta, is a public health
consultant, clinical research volunteer and policy advocate keen on eliminating
the stigma around HIV.
"Some people believe
that people living with HIV are 'sick,' or look unwell,"
she says. Martinez also stated, "For me,
I knew I was in good health. HIV was no longer a legal barrier to organ
donation, and I never considered HIV to be a medical barrier either. As a
policy advocate, 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."
July 2018 through Facebook, Martinez found that a friend living with HIV was in
need of a kidney transplant. As someone familiar with
the medical research process and public health policy, she
reached out to John Hopkins as she felt obliged to help her friend.
discussing the possibility of donating a kidney with Dr. Segev, Martinez
traveled to The Johns Hopkins Hospital in Baltimore in October 2018 to undergo
a medical evaluation. Multiple trips were made for analysis to ensure that she
was healthy enough to donate, a standard procedure followed in all potential
living kidney donations.
before Martinez was declared fit for the surgery, her friend passed away. After
the funeral, Martinez contemplated the
options available and decided that she was willing to donate to an anonymous recipient,
while she was grieving her friend.
her decision, Martinez remarked, "Despite
losing my friend to kidney disease, I wanted to move forward with a donation as a way to
honor them. I could do this for someone else, not because I'm special but
because I'm strong. Other people living with HIV before me participated in
clinical research so that I could not just survive but thrive. It was my turn
to do this, for both my friend that I cared about and all people waiting on a
the medical evaluation, the surgical team found Martinez to be having healthy
kidneys and a low viral load, meeting the criteria laid down by the HOPE
federal safeguards. After being cleared, Martinez successfully donated a
kidney to an anonymous recipient.
Donation - The Background
a study, whose results appeared in a 2018 American
Journal of Transplant
article, surgeons studied the factors that could help
identify candidates healthy enough to donate a kidney. Potential donors should have well-controlled HIV, no history of
diabetes, blood pressure under control
and normal protein levels in their urine.
the donor and recipient will be closely monitored by the physicians. With the
availability of highly effective antiretroviral therapy
options and prediction factors, the HOPE in Action team is
positive that long-term HIV control and kidney function will be exceptional.
HIV Organ Donation -
Why is it Important Today?
to the data available from United Network for Organ Sharing, as on March 2019, there are about 113,000 people on the transplant waiting list in
the US. The longest waitlist is for kidneys and an average of 20 Americans die
due to organ unavailability. In this scenario, people living with HIV,
volunteering to donate, could potentially save the lives of thousands of others
living with HIV, requiring transplants every year.
the Johns Hopkins' breakthrough transplant in 2016, under the HOPE Act, there have been more than 50 deceased donors and over 100
under a HOPE
protocol in the US. References :
- First Ever Living Donor HIV-To-HIV Kidney Transplant- (https://www.hopkinsmedicine.org/news/newsroom/news-releases/first-ever-living-donor-hiv-to-hiv-kidney-transplant)