In A Medical Breakthrough – HIV Infected Organs Used In NHS Transplant For The First Time

[JANASENA]

 

The groundbreaking medical feat took place at Guy’s Hospital in Southwark, Central London in May 2015 and was revealed last week. This is the first time ever that organs infected with HIV have been used in NHS transplants. Over the last five years, two people donated their liver while two people got kidneys. The kidney transplants were performed by Nikolas Karydis and have been successful. After Guy’s Hospital gave the good news, Queen Elizabeth Hospital in Birmingham has revealed that it has successfully carried out HIV liver transplant surgery. This has been hailed as one of Britain’s biggest medical advances in decades. Prior to this someone suffering with HIV was not allowed to donate organs to anyone.

Since patients suffering with HIV and their families are often stigmatized, the names of the donors and patients have not been revealed, but the wife of one of the kidney recipients told The Mirror that she was “forever grateful” to the donor for this extraordinary second lease of life to her husband who had one of his foot in the grave. She chose to share her story so that more patients who are HIV infected may think of donating their organs in the event of death, so as to help other HIV infected friends.

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How it happened:
For the sake of simplicity let us call the kidney recipient Mr K. He is the first HIV-infected kidney recipient in the UK and the first person in the world outside South Africa to receive an HIV-infected kidney. Based in London, the 40-year-old man had discovered he was HIV-positive 15 years ago. Five years later he was diagnosed with end-stage kidney failure. Since 2006 until the transplant last year, he had to undergo debilitating dialysis thrice a week.

It was when his kidneys functioning dropped to 8 % capacity that the doctors suggested surgery. He was skeptical about the transplant but listened to the advice and decided to think about it. His wife had personal reservations and nervousness about the safety of the operation, but she stood by her husband’s side. However, after weighing the pros and cons of the procedure, Mr K told the team of doctors, ”You’ve got to take a risk sometimes in life, so I will go for it.”

The surgeons had spent months seeking approval from senior officials at NHS Blood & Transplant before proceeding with it.

When Mr K woke up after the operation he “felt strange” because he needed to pass urine for the first time in four years. After 20 days of observation he was discharged from the hospital with a fully functioning kidney. There was no need for dialysis any more. Hence, he feels less exhausted, more active, in better health and looks 10 years younger than before the surgery. 12 months down the line, the couple has no complaints and only gratitude.

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Risks involved:
In any kind of organ transplantation the compatibility of donors and recipients has to be carefully evaluated. If an HIV-positive patient receives a HIV infected organ, there is always a risk of super-infection, in which a different strain of HIV could cause serious harm. Hence, in such a case of HIV-positive donors, the medical team has to additionally analyze how their HIV has been treated. It has to be ascertained if the donor had any infections or illnesses associated with more advanced stage of HIV.

“Surgeons will use this information to balance the risks of using an organ from someone with HIV with the risk of their patient dying while waiting for another organ to become available,” according to Professor John Forsythe, NHS’s top transplant donor.

The recipient has to be fully informed about the procedure, the risks involved and has to accept the risks. The donors, the recipients and their families have to agree to the entire procedure. The donors’ families have to be prepared to make this decision to donate the organs at a very emotional moment of their lives.

Doctors, too, have to be careful so that they do not themselves contract the fatal virus while performing the surgery. Although this risk is small, according to Dr Karydis, the surgical staff has to cover all exposed body parts and double up on gloves and face masks.  At present, the entire medical team is feeling proud to reveal the success of the HIV-organ transplant.

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What this medical breakthrough means for the other patients:
To begin with, those patients who are usually stigmatized due to their HIV-positive status will be encouraged to overcome their fear of receiving infected organs from similar patients. Such infected organs from HIV-positive patients will not be lost. This has been made possible by improvements in treatment of HIV-positive patients. Such kinds of innovations make way for possibilities of donation where there they did not exist earlier.

Dr Rachel Hilton, a consultant kidney specialist at Guy’s Hospital, said: “We now know we can accept organs from deceased patients with well-controlled HIV, to give to other HIV-infected patients on the transplant waiting list.” This is remarkably good news for UK’s 1 00 000 HIV patients. No wonder HIV charities across the nation are celebrating!

This in turn means more healthy organs will become available for thousands of patients waiting desperately for organs from healthy donors who are not HIV-positive. This would reduce shortage of donor organs. 6, 500 patients across the UK are in desperate need of a transplant. “On average three people a day die in need of a transplant” reveals Professor John Forsythe, the body’s associate medical director for organ donation and transplantation.