On Monday night, the HIV Organ Policy Equity (HOPE) Act (S. 330), legislation co-authored by Rep. Lois Capps, D-Santa Barbara, Rep. Andy Harris of Maryland, Sen. Barbara Boxer of California and Sen. Tom Coburn, M.D., of Oklahoma, passed the U.S. Senate by unanimous consent.
The bill would create a science-based path for medical research to proceed on the feasibility, effectiveness and safety of HIV-positive to HIV-positive organ transplants. Senate approval of the legislation is a significant step forward, and S. 330 will now move to the House for consideration.
“I am grateful to leadership of Sen. Boxer and Sen. Coburn for getting this common-sense, science-based legislation through the Senate,” said Capps, co-author of the legislation, member of the Energy and Commerce Committee’s Health Subcommittee and a nurse. “The HOPE Act must be passed in order to allow for research on the feasibility and safety of HIV-positive to HIV-positive organ transplants. If shown to be safe and effective these types of transplants will help with the growing need for organ transplants for HIV-positive individuals and will help reduce long transplant wait times overall. I look forward to continuing our efforts in the House and hope the House will consider S.330 quickly.”
“With recent events reminding us of the need for more organs for transplantation, this legislation will increase the number of organs available for transplantation and will save lives,” said Andy Harris, M.D. “I am encouraged that the Senate took bipartisan action on this commonsense, scientifically sound legislation.”
Currently, a blanket ban enacted in 1988 prohibits acquiring, even for research, organs “that are infected with the etiologic agent for acquired immune deficiency syndrome.” The bill would strike this outdated standard and create a potential pathway for HIV-positive organs to be donated to HIV-positive patients.
The legislation would lift the ban on HIV-positive organ transplantation and charge the Department of Health and Human Services with setting up a research protocol to determine the effectiveness of positive to positive transplants while ensuring the safety of the existing transplant system. HHS would subsequently evaluate the results of the research to determine if HIV-positive organ donation for HIV-positive transplant patients is effective and safe.
The explicit ban on acquiring HIV-positive organs for any purpose, including research, was included in the Organ Transplant Amendments of 1988 when very little was known about HIV/AIDS and few treatments were available. As HIV treatments like Highly Active Antiretroviral Therapy (HAART) have become more effective, however, patients with HIV are living longer, fuller lives. But they also are more likely to experience other life-threatening conditions including kidney and liver failure, which require organ transplants. It has been estimated that liver disease accounts for 40 percent of deaths in people with HIV – which would make it the leading cause of death. Kidney disease is estimated to affect about 30 percent of people with HIV and cause more than 10 percent of HIV-related deaths.
According to a study published in the American Journal of Transplantation, allowing HIV-positive organ donation to HIV-positive transplant patients could increase the organ donation pool by 500-600 donors, potentially saving hundreds of lives. Moreover, the policy change and changes in treatments could potentially save Medicare dollars by reducing the need for kidney dialysis. Currently, treating patients experiencing kidney failure is responsible for six percent of Medicare’s annual budget. Moving more patients from dialysis to transplantation could result in both better patient outcomes and lower Medicare costs.
Identical versions of the HOPE Act were introduced for the first time in both chambers on Feb. 14 in honor of National Donor Day. Minor changes were made to the Senate version of the HOPE Act (S. 330) in the Health, Education, Labor, and Pensions (HELP) Committee and on the Senate floor before passage. Congresswoman Capps supported the changes and is working to get the House to proceed with consideration of S. 330 soon.
The legislation has support from a broad coalition of members of the medical community as well as advocacy groups, including the American Society for Transplantation, American Society of Transplant Surgeons, Dialysis Patient Citizens, HIV Medicine Association, United Network for Organ Sharing, Human Rights Campaign, Organization for Transplant Professionals, American Society for Nephrology, American Transplant Foundation and Association of Organ Procurement Organization.
— Ashley Schapitl is press secretary for Rep. Lois Capps, D-Santa Barbara.