August 15, 2013

World’s first live kidney donation by HIV carrier and transplant into another carrier announced by Tel Aviv Sourasky Medical Center

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Photo by: Keith Bedford / Reuters

By JUDY SIEGEL-ITZKOVICH
15/08/2013

The surgery took place a few months ago, the hospital says, and the recipient has returned to work and normal functioning.

Reportedly for the first time in the world, a woman who is an HIV carrier has donated a kidney to her husband who also is a carrier of the AIDS virus, Tel Aviv Sourasky Medical Center reported on Tuesday. The surgery took place  a few months ago, the hospital said, and the recipient has returned to work and normal functioning.

In South Africa, kidneys for transplant are taken from individuals whose lower-brains have died (but whose hearts still beat).

The Tel Aviv transplant required a long and careful preparation by the interdisciplinary transplant team that included doctors from the hospital’s AIDS center and its transplant center, as well as  psychologists and social workers.

The procedure is complicated by the need to change the drugs taken by the HIV carriers to raise the prospects for success and prevent conflicts between drugs to minimize rejection of the organ and medications for HIV.

“Organs from HIV carriers have never been used for transplant before anywhere in the world, except in South Africa, where it has been done successfully using organs from brain-dead patients for many years,” said Dr. Roni Baruch, head of Sourasky’s transplant clinic. “On the basis of the South African experience and the growing awareness that HIV is no longer the fatal disease it used to be, there is recognition in the Western world of the possibility that HIV carriers can undergo lifesaving organ transplants. Of course, such organs will be given only to HIV carriers themselves.”

The couple involved were a man who had been on dialysis for two years and his wife -- both of them HIV carriers. Following the surgery, whose date was not given, both are under close observation to ensure that their kidney function and immune systems are stable. “The fact that this was the first live-kidney transplantation between HIV carriers gives a new perspective for medicine with HIV carriers, said Dr. Yvgeny Katzman, an infectious disease expert at Sourasky’s AIDS center.

The doctors said that due to much experience in South Africa with kidney and even liver donations from brain-dead patients to HIV patients, the success rate of transplants has risen to be almost equal to those of non-carriers. Liver and kidney infections are quite common among HIV carriers, they added.

The participants in the surgery are preparing an article about Israel’s first live kidney donation and transplant between HIV carriers that will be published in a medical journal. The case will also be presented at medical conferences in Israel and abroad.

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