New rule allows HIV-positive kidney and liver transplants in the US

People with HIV who need a kidney or liver transplant can receive an organ from a donor with HIV, under a new rule announced Tuesday by U.S. health officials.

Previously, such transplants could only be performed as part of research studies. The new rule, which comes into effect on Wednesday, is expected to shorten the wait time for everyone, regardless of HIV status, by increasing the supply of available organs.

“This rule removes unnecessary barriers to kidney and liver transplants, expands the organ donor pool, and improves outcomes for transplant recipients with HIV,” U.S. Secretary of Health and Human Services Xavier Becerra said in a statement.

The practice’s safety is supported by research, including a study published last month in the New England Journal of Medicine. That study followed 198 organ recipients for up to four years, comparing those who received kidneys from HIV-positive donors with those whose kidneys came from donors without HIV. Both groups had similarly high rates of overall survival and low rates of organ rejection.

In 2010, surgeons in South Africa provided the first evidence that the use of HIV-positive donor organs was safe in people with HIV. But the practice wasn’t allowed in the US until 2013, when the government lifted the ban and allowed research studies.

Initially, the studies were on deceased donors. Then, in 2019, a team from Johns Hopkins University in Baltimore performed the world’s first kidney transplant from a living donor with HIV to an HIV-positive recipient.

Five hundred kidney and liver transplants have been performed in the US from HIV-positive donors.