Heart transplant

World’s first HIV-to-HIV heart transplant

Doctors at a New York hospital have performed the world’s first successful heart transplant between an HIV-positive donor and an HIV-positive recipient, according to a press release from Montefiore Health System in the Bronx, where the operation took place this week. spring.

The recipient, a woman in her 60s who suffered from advanced heart failure, also received a simultaneous kidney transplant. The life-saving four-hour operation took place this spring and the recipient remained in hospital for five weeks while recovering.

“Thanks to important medical advances, people living with HIV are able to control the disease so well that they can now save the lives of others living with this disease,” said Ulrich P. Jorde, MD, heart transplant specialist at Montefiore and professor of medicine at Einstein College of Medicine, in the press release. “This surgery is a milestone in the history of organ donation and offers new hope to people who once had nowhere to turn.”

The groundbreaking transplant took place nearly a decade after the HOPE (HIV Organ Policy Equity) Act was passed by Congress and signed into law by then-President Barack Obama in 2013. Before that, transplants between two people with HIV were illegal.

The first HIV-to-HIV transplant didn’t happen until 2016, when Johns Hopkins Medical Center in Baltimore performed the nation’s first organ transplants (a kidney and a liver) from an HIV-positive donor to recipients. HIV positive. These two transplants, like most after them, involved a deceased HIV-positive donor.

In 2019, Nina Martinez, a 36-year-old Atlanta woman who contracted HIV through a blood transfusion as a newborn, became the first living HIV-positive kidney donor.

Wait times for heart transplants are long — often more than six months, reports The Bronx Times — and the transplanted heart cannot be placed in cold storage for more than four to six hours.

The heart transplant recipient at Montefiore had been on a waiting list “for quite some time,” his cardiologist, Omar Saeed, MD, assistant Einstein professor of medicine, told the Bronx Times. So, to increase his chances of finding a donor, Saeed and the medical team discussed the possibility of receiving a transplant from another HIV-positive person. “She was really, really good with [that] and accepted the risks and benefits and signed the consent,” Saeed said, adding, “This is a major achievement for us. But for me, I’m in awe of his bravery and just marveled at his strength.

Montefiore is one of 25 medical centers in the United States capable of offering surgeries like this.

“The goal of the Montefiore Heart Transplant team is to constantly push and set new standards so that anyone suitable for an organ transplant can benefit from this lifesaving procedure,” added Daniel Goldstein, MD, professor and specialist in cardiothoracic surgery at Montefiore. and the Albert Einstein College of Medicine.

“This was a complicated case and a true multidisciplinary effort from cardiology, surgery, nephrology, infectious disease, critical care and immunology,” Saeed added. “Making this option available to people living with HIV expands the donor pool and means that more people, HIV-positive or not, will have faster access to a vital organ. To say we are proud of what this means for our patients and the medical community as a whole is an understatement.

In the United States, between 60,000 and 100,000 people could benefit from a new heart, according to Montefiore. However, only around 3,800 transplants were performed in 2021.

In addition, the federal government revised the guidelines for organ transplants in June 2020, which could lead to an increase in organ donations. Notably, the update included new criteria for identifying potentially undetected donors of HIV and hepatitis B and C viruses (HBV and HCV). Thanks in part to advances in testing and treatment, more organs can now be accepted from people who would have been classified as an increased-risk donor.