City docs transplant liver into HIV+ man
In a rare surgery, doctors at Sir Ganga Ram Hospital recently performed a liver transplant on an HIV positive person. The patient, a 45-year-old man from northeast, has been living with HIV since 2003. He contracted Hepatitis C leading to liver failure.
The family of the patient said the local hospitals they approached had given up, saying there was no cure for this complex condition. So, they rushed him to Delhi where the transplant was carried out.
“It took us over 10 hours to carry out the life-saving procedure. We had to be very careful not to catch the infection. At the same time, we had to ensure that the patient didn’t contract any infection post transplant,” said Dr Naimish Mehta, senior liver transplant surgeon at SGRH.
He said HIV patients are generally not taken up for major surgeries, particularly transplants, because they are immune-compromised.
“In this case, for example, the patient had both HIV and Hepatitis C, which compromised his immunity significantly. Additionally, we had to suppress his immune system post transplant to ensure that the body doesn’t reject the new liver,” Mehta said.
The liver transplant surgeon added that this was a huge challenge for them and any misstep could have proved fatal.
The liver transplant surgeon said both the donor and the recipient were doing well.
In India, 2.1 million people are living with HIV and Hepatitis C virus co-infection, said Dr Anil Arora, chairman, department of gastroenterology at the hospital.
He added that initially HIV infection was considered an absolute contraindication for organ transplants because of concerns about disease progression.
However, with recent advances in retro-viral therapy for HIV and treatment for Hepatitis C virus infection, complex procedures, including transplants, can be carried out, the doctor added.
The US Congress recently passed HIV Organ Policy Equity Act (HOPE Act), which allows organ donation between HIV positive individuals.
“The prevalence of liver disease in patients with HIV is higher than that of the general population, as are the morbidity and mortality. But with successful transplant, it is possible to give them a new life,” Arora added.
According to the doctor, in India, the biggest hurdle for patients suffering from HIV is the stigma associated with this disease.
In many areas, HIV positive people are considered social outcasts. Worse, they are turned away by many hospitals too. “In spite of medical advances, these patients find themselves condemned for life,” said another senior doctor at Gangaram hospital.