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First heart transplant among HIV-positive patients in New York

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First heart transplant among HIV-positive patients in New York

The organs to be transplanted are so precious and in demand that they absolutely cannot be “wasted”. Even if they are not one hundred percent “perfect” as you would like. Especially in the most desperate cases, when the sick are left with no other chance of survival.

This was probably what prompted a group of New York doctors to risk a procedure never done before: a heart transplant between HIV-positive patients. Until last spring, when this revolutionary procedure was performed, no one had ever dared so much. But the risk was worth the result, at least for the moment.

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Who is the woman who has received new organs

The woman of about sixty years of age, HIV positive, who received the “infected” organ, and at the same time also a kidney, is recovering well and there is a good chance that her life will be longer and better thanks to this “life-saving” transplant. The entire procedure was performed at the Montefiore Health System in New York City, which for years had been evaluating the possibility of using this type of intervention. Until 2013, organ transplants from HIV-positive donors were strictly prohibited in the United States. Then nine years ago the HIV Organ Policy Equity (HOPE) Actnel was passed, which allows transplants between HIV-positive people in an experimental setting. But now that we have proof that it works, the hope is to be able to resort to this procedure more often, at least to clear the long waiting list of those waiting for an organ.

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The hospital asked the patient for consent

It is estimated that there are over 100,000 Americans in the US waiting for a new organ, and more than a dozen people die every day waiting for their turn. For comparison, only about 40,000 transplants are performed each year. The remaining patients have nothing left to do but wait and hope to survive.

Hearts to transplant, in particular, can be difficult to find. Beneficiaries must hope for a suitable donor whose cause of death did not damage the organ. Aware of these difficulties, the New York doctors have decided to speak directly with their patient about the possibility and risks of a heart transplant taken from an HIV-positive person.

The woman suffered from advanced heart failure

The woman suffered from advanced heart failure and had been expecting a heart for some time. “She’s been waiting for some time and we thought why don’t we talk to the patient? And she accepted the risks and benefits, and she signed the consent,” she told the Bronx Times Omar Saeed, a cardiologist with the Montefiore Health System of New York City. The surgery lasted four hours and was immediately a great success. After five weeks in the hospital, the woman is now continuing her recovery at home.

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The situation in Italy

“This is great news,” he comments Mauro Rinaldi, director of the Complex Structure of Cardiac Surgery of the University Hospital of the City of Health and Science of Turin. “It is the first time that the heart of an HIV-positive donor has been transplanted into another HIV-positive patient, but it is not the first time that an organ from an HIV-positive donor has been used. In the past, also here at Turin, it was done – he continues – with organs other than the heart and the results have been positive “.

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The American recipient was HIV positive, so she would not have contracted the HIV virus because of the organ. “Moreover, with the advances in antiretroviral therapy, the HIV virus is no longer a death sentence, but it is perfectly controllable and therefore the road to transplantation has become even more viable,” adds Rinaldi.

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Long before HIV, organs from donors with HCV, the hepatitis C virus, began to be transplanted in Italy and in many other countries around the world. “In this way the availability of organs – kidneys, heart, lungs, etc. – has increased considerably “, underlines Rinaldi.

Perhaps we are still a long way from being able to use the hearts (or other organs) of animals for so-called xenografts or from creating organs in the laboratory, but the possibility of using organs that are “not perfectly healthy” is already a reality. “He has already saved the lives of many people today”, concludes Rinaldi.

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