Submitted by qutronix t3_yufck3 in askscience
My logic looks something like this. The danger of transplants is that our immune system will constantly try to kill transplanted organ. To prevent this, we take immunosupresant drugs that weaken our immune system to the point it cant effectively kill our organs. AIDS weakens our immune system. Thus we dont need additional weakening.
First HIV positive recipient in USA received a live donor liver transplant in 1999 at New York’s Mount Sinai Hospital. She is alive and well today and living a full and fabulous life. Immunosuppressive meds are necessary but were adjusted significantly due to HIV positive diagnosis. At the time, only New York’s Mount Sinai Hospital and a hospital in Richmond, Virginia were willing to take the case.
I wonder if they reduced the dose or took away the synergistic drug in the combo. That’s cool to hear!
They didnt changed HAART 100%
Or are you talking about synergistic drug in immunosuppression?
Yes, HIV targets mostly Helper Tcells, you still have quite a bit of immune system left even after you have AIDS that could kill the transplant. So you would need to take immunosuppressants.
That being said the question most of the other comments seem more interested in would be if someone with AIDS would be a candidate, and I think a lot of the answers people are coming up with are flawed.
If someone happened to be in liver/kidney failure and it was somehow discovered that they had also had undiagnosed HIV/AIDS or an AIDS defining infection, they would unlikely be a candidate for transplant until their concomitant infections were resolved and they were undetactable and showing some improvement with cd4 count, if they survive to that point they would potentially get listed and potentially get a transplant, especially from an HIV positive donor.
In the US at least, we are pretty good about screening and catching HIV infections so that people live with the virus for a long time.
just so you know.. there are plenty of medical reasons that make you INeligibile.. sometimes it depends on the transplant.. (kidneys can be donated - heart lungs not so much). - living donors.
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lifelong smoker with messed up lungs not eligible.
need a liver because you drank too much? doubt it.
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full blown AIDS patient might be able to get a kidney from matched donor..
possibly not for anything else.. (shorter expected life)
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HIV can be managed for decades
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Organ Transplants for HIV/AIDS Patients
Until recently, people who had HIV were not considered good candidates for organ transplantations. Many patients were denied transplants under the assumption that they had shorter life expectancies and less favorable survival rates than other patients in need of transplants. However, now that patients are living longer lives, many groups are re-considering whether HIV patients should be transplant candidates.
>Thus we dont need additional weakening.
it's not a yes/no.
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Since HAART prolongs the lives of HIV patients, it is possible for chronic conditions to progress to organ failure. For instance, HIV patients may experience end-stage liver disease as a complication of chronic hepatitis C virus. Glomeruli diseases are also common among HIV patients, and they may lead to kidney failure. In advanced stages of liver or kidney damage, organ transplants may be the patient's only chance of survival.
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penicilling t1_iw98lxu wrote
>Would person with AIDS need to take immunosupressants for transplated organs?
Well, it's complicated.
First of all, AIDS is the acquired immunodeficiency syndrome. The HIV virus (human immunodeficiency virus) will, if untreated, eventually result in AIDS. People with AIDS are at very high risk for all sorts of infections, and if the HIV doesn't get treated, and if prophylactic antibiotics are not used, then they will ultimately die, often from infection, cancer, or both.
So if you have AIDS (as opposed to being HIV positive without immunodeficiency), you are at very high risk for serious problems, and you would not be a candidate for any kind of elective surgery, and certainly not a major surgery like an organ transplantation.
Until recently, even having HIV was generally a contraindication to getting an organ transplant. Because people with HIV have shorter lifespans, and because of the need for lifelong immunosuppressive medications, it was not thought that it was either a good use of limited resources, plus there is a risk that immunosuppressive medications could strongly interfere with HIV treatment.
Recently, some transplant centers have begun organ transplantation in HIV-positive patients. But we don't know whether this is going to result in longer lives for HIV-positive patients, as there could be worsening of HIV and the development of AIDS.
Now to specifically answer your question: no one really knows what to do in a situation like an HIV-positive patient with an organ transplant who develops AIDS. It's a no-win situation, and the person might well develop serious infections, organ rejection, or both.