Patient Alexandra Harry, center, with her Mount Sinai clinical team, from left: Shirish S. Huprikar, MD; Susan Lerner, MD; Brandy Haydel, Clinical Research Program Director; and Sander Florman, MD.
The Mount Sinai Hospital recently became the first hospital in New York State and
the second in the nation to perform a kidney transplant from an HIV-positive deceased donor to an HIV-positive recipient, the result of federal legislation that went into effect late last year making such transplants possible.
Led by Sander Florman, MD, Director of the Recanati/Miller Transplantation Institute, and the Charles Miller, MD Professor of Surgery, Mount Sinai is one of four medical centers in the country with federal approval to perform liver and kidney transplants under the HIV Organ Policy Equity (HOPE) Act.
“The new law is a win-win for everyone,” says Dr. Florman. “This represents the potentially largest increase to the organ donor pool in many years and could provide more organs for everyone.”
Prior to the HOPE Act, organs from HIV- positive donors were not legally allowed to be procured for transplant into patients with HIV—the only people eligible to receive them—which made organ waiting lists longer for all patients, including those without HIV. The average wait for a kidney from a deceased non-HIV donor is seven years in New York, according to Dr. Florman.
Alexandra Harry, 55, the first Mount Sinai patient to receive a kidney under the new law, called the transplant “a gift that has given me the opportunity for a better quality of life.” Since 2005, she had been on peritoneal dialysis, which had to be performed 10 hours each night. Ms. Harry says she learned about her eligibility to participate in Mount Sinai’s program only two weeks before she actually received
a suitable kidney, so the entire process was very quick.
A few days after her surgery this past spring, Ms. Harry said, “I felt an improvement almost immediately.” Her surgeon was Susan Lerner, MD, Assistant Professor of Surgery and Medical Education at the Recanati/Miller Transplantation Institute. Shirish S. Huprikar, MD, Associate Professor of Medicine and Director of Transplant Infectious Diseases at the Recanati/Miller Transplantation Institute, worked closely with the team to evaluate the appropriateness of HIV-positive donors.
According to Ms. Harry’s son, Aaron, 35, the transplant will enable his mother to travel more freely and see her extended family more frequently without the burden of carrying the medical supplies and equipment needed for her dialysis. “With this kidney, I see more
doors opening,” he says.
Johns Hopkins Medicine in Baltimore and Mount Sinai were the first to perform the transplants. Like Ms. Harry, all recipients must agree to participate in clinical research approved by each hospital’s Institutional Review Board under criteria set by the National Institutes of Health. Hahnemann University Hospital in Philadelphia and the University of California, San Francisco Medical Center also have permission to perform these transplants.
At Mount Sinai, there are currently about 80 HIV patients waiting for a kidney transplant and 12 waiting for a liver transplant, says Dr. Florman. It has been estimated that this new source of organs could be enough for as many as 2,500 additional deceased donor transplants in the United States each year.
Dr. Florman recently participated in an Organ Summit in Washington, D.C., hosted by the White House. At the summit, senior administration officials and transplant specialists from hospitals, universities, foundations, and patient advocacy organizations created a Blue Ribbon Advisory Panel with the goal of establishing a national clearinghouse of educational resources about transplant and living donation for patients, living donors, and the public.
“The need for organs for transplantation far exceeds the availability, and the waiting lists continue to grow,” says Dr. Florman. “People’s lives depend on these efforts, so we must find ways to increase the donor supply and also encourage living donation.”