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HIV-positive woman donates kidneys to HIV-positive recipients in the world



Nina Martinez, a 36-year-old public health consultant, became HIV-infected at the age of 6 in 1983, when she received a blood transfusion in the years prior to blood tests. HIV damages the immune system and impairs the ability of the body to fight against the organisms that cause disease.

Despite her illness, Martinez's persistent spirit is audible.

"I want people to really think about what it means to live with HIV," she said from her hospital bed two days after her operation. "If someone proves that you can live with HIV for a lifetime, then I am. I have been living with HIV for 35 years – about as long as the epidemic in the United States."

Dr. Dorry Segev, a professor at the Johns Hopkins University School of Medicine and the surgeon who carried out the operation of Martinez, said the historic operation was "truly a celebration of HIV [medical] care and development".

People with HIV "HOPE" given

Until 201

3, the United States did not allow HIV-positive organ donation, Segev said, "I've seen people with HIV die on our transplant list. I've watched each one of us No, no one believed that HIV donor transplants were possible for two reasons: the virus itself can damage the kidney and controlling HIV – are toxic to the kidney. "We had to show that certain people with HIV can be healthy enough to be a kidney donor and live with just one kidney," Segev said.

As people live longer with HIV, they suffer more kidney failure associated with high blood pressure, diabetes, and heart disease, Martinez explained. "Because people living with HIV are disproportionately affected by the length of the donor's waiting list, you die with HIV almost twice as often while waiting for a kidney," she said.

The adoption of the HIV Organ Policy Equity (HOPE) Act in November 2013 enabled researchers to conduct studies on organ transplants from HIV-positive donors to HIV-positive recipients. The law does not give priority to HIV-positive patients, but provides a pool of donors specifically for people living with HIV.

  HIV / AIDS Fast Facts
Martinez was not enthusiastic about the HOPE Act because she knew it would be used primarily to become an organ donor to deceased HIV-positive patients . This was the case when Johns Hopkins performed the world's first HIV-to-HIV transplant in 2016.

Until their own operation on Monday, there were approximately 100 HIV-to-HIV transplants in the United States, but all of them were deceased donors.

An episode of the television program "Gray's Anatomy," which featured a fictional HIV-to-HIV live donor transplant, provoked Martinez's fantasy.

"It was not until my friend aired his need for a kidney that I seriously thought about it," she said. An internet research led her to Johns Hopkins.

"Unfortunately, my friend died," she said, and her donation went to an unknown person, a good match picked from Johns Hopkins' kidnapping list. 19659002] To fulfill her dream, Martinez had to be carefully screened.

A second strain of HIV

"Nina met the donor criteria: otherwise, she was healthy without hypertension and diabetes, and her only additional risk factor for kidney disease was HIV. Based on our research, we found that this represents an acceptable and low additional risk, "said Dr. Christine Durand, Associate Professor of Medicine and Oncology and member of the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center and the HIV Team Specialist for Martinez Surgery.

Martinez said access to health care has "made a big contribution" to her health and longevity. She has not had a car for 14 years, so she goes a lot. She also runs marathons with the grassroots charitable project, where student athletes teach adolescents the principles of HIV prevention. "I found the juxtaposition of a long-time HIV patient with NCAA Division I athletes quite funny," she said.

  Two men could be cured of HIV second and third

Martinez & # 39; s HIV is also under Durand said "excellent control," measured by T-cell counts and undetectable levels of virus in the blood.

Segev said, "The nice thing is that the operation itself was like the hundreds of other live donor surgeries I did, it was just a regular live donor operation."

On the day of the operation, Martinez ran through the halls "He was fine," he added. The receiver is fine too. The kidney works wonderfully.

Durand said that "the medically novel thing about it is that the recipient is likely to receive a second HIV strain from the donor – something we call HIV superinfection," as is the case with all HIV-to-HIV transplants

Donors and recipients must be compatible with HIV drug resistance, she said, however, when the recipient buys the new HIV strain, their drug treatment will continue to function. "We can, if necessary, take the drugs But we need to have a plan for that, "Durand said.

Initiative to Reduce New HIV Infections

During his State of the Union address in February, President Donald Trump called for the abolition HIV transmission in the United States by 2030. Last week, the US Department of Health and Human Services redefined an initiative to reduce it He presented HIV infections in the United States by at least 90% over 10 years.

There are more than 1 million people living with HIV in the United States. Martinez & # 39; s historic operation means to them, "Here's a stigma less related to this disease," Segev said.

From the moment she made her decision to end the operation, the organ donor process took about nine months. Martinez said, "I have a very strong confidence in myself as if I were my own rock, so if I've made unusual decisions or made decisions where I do not know the result, I just squat and believe in myself and usually this will get me through it, and some people may call it stubborn. "

Martinez hopes that her gift will inspire other people – whether they are HIV negative or positive – to become living organ donors.

"We have a very serious organ deficiency in this nation," she said. "It's a really concrete way to make a difference."


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