Ethicist Art Caplan discusses the use of organs from donors with viral infections to increase the available supply for transplantation.
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It’s partly due to the fact that there are more people eligible for transplant as transplantation improves, with sicker people, older people, and indeed younger people entering the waiting list, meaning young children. For a variety of reasons, people in the US have not been able to donate organs upon death at a rate that keeps up with this demand.
You can give the recipient antiretroviral therapy . It’s very successful in keeping viral infections of people who are HIV positive to a minimum. If you take it as prescribed, probably 95% of people maintain almost undetectable levels of HIV virus in their blood, so you know that you will be able to treat anythat gets transmitted from an HIV-positive donor.
I think this is an ethical approach. It requires a number of steps to make sure that people are getting, if you will, informed consent to this increased risk. You have to tell them what you know about the risk for transmission. You have to tell them what we know about its prevention and treatability. Those are not 100% effective; they’re very good, but not 100%.
In all honesty, nobody’s been around with 10 years of an HIV-positive heart transplant in order to say whether the drug treatments hold up or whether the HIV in a person who’s undergoing immune suppression is going to have more of a rebound effect than in somebody who’s just getting medicines for HIV exposure.
HIV Disease HIV Transplantation Transplant Patient Safety Transplantation Of The Kidney Renal Transplantation Renal Allograft Kidney Transplantation Transplantation Of An Organ Organ Transplantation Organ Transplant Clinical Research Clinical Trials Clinical Studies Pre-Clinical Trial Double-Blind Study Double-Blind Studies Single-Blind Study Single-Blind Studies
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