After a persistent press for organ equity by ACT UP/Golden Gate, the University of California/San Francisco fired up the nation's first transplant program for HIV patients. "It's a decision based on science to benefit population that deserves transplantation," said Dr. John Lake, medical director of the program. "What prompted it is that the outlook and prognosis for people with HIV has radically improved." To be eligible for a transplant, one must have a disease with a 70 percent survival rate over five years, Lake said. But is there an AIDS-phobic-tinged hitch? PWAs get only unwanted, "high-risk" organs – from alcoholics, gay men, prisoners or the promiscuous.
"Donating organs is a very touchy-feely thing," said Dr. Steven Rudich of the University of California/Davis. He frets that anti-AIDS prejudice could provoke a decline in donations. "Many people still think of giving organs to a PWA as a waste. Donors could start specifying, ‘I don't want my loved one's organs to go into a patient with HIV.'" While Lake knocked such fears as "nonsense," he noted the special risk the gift of life poses: The immune system has to be suppressed after transplantation to prevent organ rejection – a dicey prospect for PWAs.
Jeff Getty, yesterday's AIDS poster boy following his own baboon bone-marrow transplant, said the alternative to that risk has too often been death. "A friend needed a heart, and because he had HIV, doctors wouldn't even screen him. I couldn't bear to watch him die," said Getty, the point man in ACT UP's organs-into-HIVers mission. "People who give organs give then out of love, not hatred." The first transplants are likely to be liver or kidney. According to Lake, the University of Pittsburgh is the only other transplants center providing for PWAs, although the University of Pennsylvania and Michigan are looking at the UCSF policy.