US performs first organ transplant from HIV donor

02 Avril, 2019, 14:55 | Auteur: Yves Courtet
  • Organ donor Nina Martinez center poses with Dr. Dorry Segev professor of surgery at the Johns Hopkins University School of Medicine and Dr. Christine Durand associate professor of medicine and oncology and member of the Johns Hopkins Sidney Kimmel Co

A multidisciplinary team from Johns Hopkins Medicine completed the living donor HIV-to-HIV kidney transplant on March 25.

Later, Martinez, born to a naval father in San Francisco, was taken to a military hospital for a blood transfusion and there she got the virus.

Despite her illness, Martinez's enduring spirit is audible. I don't want to be anyone's hero. The doctors say both the donor and the recipient are doing well.

No one considered HIV donor transplants feasible based on two concerns: The virus itself can injure the kidney, and antiretrovirals - the drugs that control HIV - are toxic to the kidney.

"This is the first time someone living with HIV has been allowed to donate a kidney, ever, in the world, and that's huge", says Dorry Segev, M.D., Ph.D.

As people live longer with HIV, they are experiencing more kidney failure related to high blood pressure, diabetes and heart disease, Martinez explained.

For the first time, a person living with HIV has donated a kidney to a transplant recipient also living with HIV.

The decision to move forward with the transplant highlights the confidence scientists have in current anti-retroviral medication, which allows those with HIV to lead normal, productive lives. And if more people living with HIV wind up donating, it helps more than HIV-positive patients who need a kidney. Individual states that had passed laws restricting donations from people with HIV are working quickly to match federal legislation, said Segev, who help draft the HOPE Act.

Since Johns Hopkins' breakthrough transplant in 2016, there have been more than 50 deceased donors under the HOPE Act and over 100 transplant recipients under a HOPE protocol in the U.S.

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A runner who plans on making this fall's Marine Corps Marathon, "I knew I was probably just as healthy as someone not living with HIV who was being evaluated as a kidney donor", Martinez said. "Because those people need a mental reboot", she said. Familiar with the medical research process and public health policy, she contacted Johns Hopkins. "It was my turn to do this, for both my friend that I cared about and all people waiting on a transplant".

To accomplish her dream, Martinez had to be carefully screened. "A disease that was in the 1980s, a death sentence, is now so well in hand that Living with HIV can today save with a kidney donation of life - this is unbelievable". "And we had determined from our research that that was an acceptable and small additional risk", said Dr. Christine Durand, associate professor of medicine and oncology and member of the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center and the HIV team specialist for Martinez's surgery.

According to doctors, Martinez is in nearly ideal health and her viral load is undetectable. She chose to remain positive throughout the years. "I thought the juxtaposition of a longtime HIV patient with NCAA Division I athletes was quite comical", she said. She said she was also excited to become part of medical history. The recipient is also "doing great. Every successful transplant shortens the waitlist for all patients, no matter their HIV status", Durand said.

Martinez acquired HIV when she was just six-week-old in 1983.

In July 2018, Martinez read on Facebook that a friend who also happened to have HIV needed a kidney transplant. Medication today can suppress the infection to undetectable levels in many people, and President Trump recently vowed to end transmission of it in the United States by 2030. Last week, the US Department of Health and Human Services detailed an initiative to reduce new HIV infections in the United States by at least 90% over 10 years.

An estimated 1.1 million people in the U.S. had HIV at the end of 2015, according to the Centers for Disease Control and Prevention. For them, Martinez's historic operation means "that 'here's one less stigma associated with this disease, ' " Segev said. "It's a powerful statement to show somebody like myself who's healthy enough to be a living organ donor". "I could do this for someone else, not because I'm special but because I'm strong". "For me, I knew I was in good health. Some people might call that stubborn".

"I knew that I was the one that they had been waiting for", she said.

"We have a very serious organ shortage in this nation", she said.

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