The Bay Area Reporter - November 2, 2000
Jeff Getty, Survive AIDS Writers Pool

Danny's story would not be so unusual were it not for the fact that he is HIV-positive. HIV-positive patients have had little or no luck obtaining organ transplants anywhere in the U.S. But now, thanks to a new protocol at the University of California, San Francisco, and $2 million in state surplus money obtained by California Assemblywoman Carole Migden (D-San Francisco), organ transplants for folks with HIV are finally possible.

Under a similar protocol transplants are now happening at the University of Pittsburgh Medical Center as well. Pittsburgh has performed six liver transplants with five patients now surviving. The university is also performing kidney transplants but officials are keeping quiet about actual numbers until a scientific article is published (however, all signs look good).

As it turns out, many HIV-positive kidney transplant patients have loving families and hence, likely living donors. This surprising turn of events (loving family members, that is) means that many patients like Danny, who have long suffered with no hope, are now getting or becoming eligible for living-related kidney transplants. Patients who have their own donor need not wait years for available organs. And since Migden has arranged funding for the project, these days kidney transplants for HIV patients are rolling out UCSF's doors. Compared to the past rate of transplants û which was zero û one could say that UCSF is transplanting kidneys nearly willy nilly.

UCSF transplant surgeon Dr. Peter Stock and HIV specialist Dr. Michelle Roland recently presented data on results of the first four kidney transplants and one liver transplant at a community consortium grand rounds meeting held at CPMC Davies Medical Center. Stock said that all five patients are alive and well, and doing better than expected. Stock, a man not known for wearing cowboy boots, was nonetheless quite the activist in getting the recent transplants performed. At the Davies hospital presentation, Stock was nearly glowing with pride and enthusiasm. At this rate of success, he indicated that health insurance companies could soon be paying for HIV-positive transplants just the same as regular patients.

"In order for a kidney transplant to be cost-effective to the insurance companies, it has to hold for about a year and a half. This is the point that the transplant becomes cheaper than dialysis," Stock said. All of the presenters were hopeful for long-term survival of the kidney transplant patients.

Stock, Roland, and others were also on hand to thank Migden and Survive AIDS for their work in getting the transplant research funded. Normally, HIV research money cannot be approved for procedures such as organ transplantation and Migden found a creative way to get the job done. Certainly the assemblywoman had a lot to be proud of as she was handed a large bouquet of flowers and shown a plague with her name on it that will be placed at San Francisco General Hospital's Ward 84. Over the years Migden had received phone calls from desperate and dying HIV patients who needed transplants. "I simply could not ignore their needs," she said.

UCSF's Dr. Tom Coates announced that the research protocol will henceforth be called the "Migden Transplant Protocol." He went on to report developments on a national level. Many other hospitals and transplant centers are in the process of adopting the UCSF protocol and National Institutes of Health funding requests are in the works.

"If all goes well we could see over 100 kidney transplants performed on HIV-positive patients in the next year and a half," remarked Roland.

If all goes as planned and the patients survive reasonably well, one could expect the day for normal HIV organ transplantation across the entire country. Europe and Australia, which often follow U.S. transplant leads, will likely follow. What started as a small activist project at ACT UP/Golden Gate, now SurviveAIDS, with help from Project Inform and others, has had quite a significant impact on transplantation worldwide. Once again PWAs have demonstrated that the system can be changed to enable their lives to go on û to survive AIDS.

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