Bioethics Blogs

HIV and Organ Donation: From Taboo to Transplantation

Aviva Goldberg and Marie Chantal Fortin describe the benefits of organ donation between HIV-infected persons.

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The Johns Hopkins Hospital is set to begin kidney and liver transplants from HIV-infected donors to HIV-infected recipients. This will be a first for the United States. However, similar HIV-infected kidney transplants have already occurred in South Africa and a deceased HIV-infected kidney donor was used in Canada (unpublished report). In addition, it has been reported in Israel that a living donor kidney transplant was performed from an HIV-infected woman to her HIV-infected husband. The ethical justification for this new program appears well founded, and prompts us to reconsider the taboo surrounding HIV and organ transplantation.

It is clear that the organ transplant system needs to have careful methods in place to minimize the risk of virus transmission from donors to non-infected recipients. The ignoble history of HIV transmission through donated blood has cast a long shadow over blood, organ, and tissue donation. This explains the bans on donation from individuals with known infection, and the strict rules governing the allocation of organs from individuals considered to be at increased risk of undetected infection with HIV or other viruses. In rare circumstances where HIV has been transmitted through organ transplants (such as the 2007 Chicago cases and a 2009 case in New York City), we have been reminded of why such levels of caution are warranted.

Acute Liver Failure

In the course of ameliorating end-organ disease through transplantation, we should do everything possible to avoid the transmission or development of new diseases.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.