Tranplant Discrimination Against those with HIV

American Journal of Transplantation (June '05) includes a fascinating study by Sydney Halpern and others at Penn in which a study of 347 surgeons revealed that there is some discrimination against those with HIV in terms of who gets an organ, and the reasons don't make sense in clinical terms.

The 347 surgeons (56.1%) returning completed questionnaires believed that HCV- and HIV-infected patients have similar post-transplant survival (p = 0.9), but that both groups fare worse than HBV-infected patients (p < 0.00001 for both comparisons). Most transplant surgeons considered HBV- and HCV- infected patients to be appropriate transplantation candidates (p = 1.0 for this comparison), whereas one-third considered HIV-infected patients to be appropriate candidates (p < 0.00001 when compared with HBV- or HCV- infected patients). That surgeons are generally willing to transplant HCV- infected patients but not HIV-infected patients, and yet believe these groups will have similar post-transplant survival, suggests that survival estimates alone do not explain surgeons' choices. HIV-infected patients should have equal access to organs unless or until evidence emerges that they fare substantially worse than other potential recipients.

[thanks Sean Philpott]