TY - JOUR
T1 - Realizing HOPE
T2 - The ethics of organ transplantation from HIV-positive donors
AU - Durand, Christine M.
AU - Segev, Dorry
AU - Sugarman, Jeremy
N1 - Funding Information:
By the NIH (grants K23CA177321-01A1 to C.M.D, 1K24DK101828-01 to D.S.) and the Johns Hopkins University Center for AIDS Research (P30AI094189).
Publisher Copyright:
© 2016 American College of Physicians.
PY - 2016/7/19
Y1 - 2016/7/19
N2 - The HIV Organ Policy Equity (HOPE) Act now allows transplantation of organs from HIV-positive living and deceased donors to HIV-positive individuals with end-stage organ disease in the United States. Although clinical experience with such transplants is limited to a small number of deceased-donor kidney transplants from HIV-positive to HIV-positive persons in South Africa, unprecedented HIV-positive-to-HIV-positive liver transplantations and living-donor kidney transplantations are also now on the horizon. Initially, all HIV-positive-to-HIV-positive transplantations will occur under research protocols with safeguards and criteria mandated by the National Institutes of Health. Nevertheless, this historic change brings ethical opportunities and challenges. For HIV-positive individuals needing an organ transplant, issues of access, risk, and consent must be considered. For potential HIV-positive donors, there are additional ethical challenges of privacy, fairness, and the right to donate. Careful consideration of the ethical issues involved is critical to the safe and appropriate evaluation of this novel approach to transplantation.
AB - The HIV Organ Policy Equity (HOPE) Act now allows transplantation of organs from HIV-positive living and deceased donors to HIV-positive individuals with end-stage organ disease in the United States. Although clinical experience with such transplants is limited to a small number of deceased-donor kidney transplants from HIV-positive to HIV-positive persons in South Africa, unprecedented HIV-positive-to-HIV-positive liver transplantations and living-donor kidney transplantations are also now on the horizon. Initially, all HIV-positive-to-HIV-positive transplantations will occur under research protocols with safeguards and criteria mandated by the National Institutes of Health. Nevertheless, this historic change brings ethical opportunities and challenges. For HIV-positive individuals needing an organ transplant, issues of access, risk, and consent must be considered. For potential HIV-positive donors, there are additional ethical challenges of privacy, fairness, and the right to donate. Careful consideration of the ethical issues involved is critical to the safe and appropriate evaluation of this novel approach to transplantation.
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U2 - 10.7326/M16-0560
DO - 10.7326/M16-0560
M3 - Article
C2 - 27043422
AN - SCOPUS:84979561616
SN - 0003-4819
VL - 165
SP - 138
EP - 142
JO - Annals of internal medicine
JF - Annals of internal medicine
IS - 2
ER -