When demand for organs continually outstrips supply, offering transplants to patients with infectious diseases, such as HIV, remains controversial. For those needing heart and lung transplants, it's not only controversial but somewhat uncharted territory. Only in the last few years have organ transplants even been offered to HIV-positive patients, much less performed; and most of the procedures have been liver and kidney transplants.
"While there are no prospective data in heart and lung transplantation, this is an area that merits careful investigation," said Jay A. Fishman, M.D., Infectious Disease Division, Massachusetts General Hospital and Harvard Medical School. "Recent data suggest that transplantation can be safely performed in selected individuals infected with HIV if viral infection can be controlled by highly-active anti-retroviral therapy."
Managing anti-rejection drugs and anti-retroviral therapies presents quite a challenge. Transplant teams must achieve just the right balance between the two types of drugs because of interactions and toxicity. Suppressing the immune system too much with high doses of the anti-rejection drug may allow a viral infection to worsen; too low a dose and the organ may be rejected.
In an effort to advance the science and treatment of heart and lung transplantation in patients affected by infectious disease, the ISHLT together with the American Society of Transplantation (AST), is sponsoring a joint symposium for the first time. Research and commentary is being presented and discussed by experts from around the globe on: