# HIV+ = ineligible for Liver Transplant?
**URL:** https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097
**Category:** Factual Questions
**Created:** [December 5, 2001, 8:45pm UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097 "2001-12-05T20:45:45Z")
**Posts on this page:** 16
**Page:** 1
### Author:  [@DMark](https://boards.straightdope.com/u/DMark)
#### Post date: [December 5, 2001, 8:45pm UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/1 "2001-12-05T20:45:45Z")
I have a friend who might need a liver transplant, but his doctor implied that because he is HIV+, he is automatically ineligible to be put on a waiting list.
Is this truly a national guidline or homophobic doctor?
He does not have AIDS, he is HIV+ and with the meds, the HIV is even undetectable. Other than his liver problems, he would be in perfect health.
I have looked on Google but could not find HIV+ as a specific disqualifyer…anyone know a source to verify this (mis)information?
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### Author:  [@peepthis](https://boards.straightdope.com/u/peepthis)
#### Post date: [December 5, 2001, 8:58pm UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/2 "2001-12-05T20:58:17Z")
You know that straight people can get AIDS too, right?
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### Author:  [@peepthis](https://boards.straightdope.com/u/peepthis)
#### Post date: [December 5, 2001, 9:07pm UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/3 "2001-12-05T21:07:04Z")
From the [Liver Transplant Program and Center for Liver Disease](http://www.livertransplant.org/livernewsletter-selectingcandidatesforlivertransplatation.html):
> [@](#):
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> There are no age limits when considering patients for liver transplantation. The absence of significant disease in the heart, brain, lungs, and kidney would favor consideration for transplantation regardless of age. A patent portal or superior mesenteric vein is necessary for successful engraftment. If evidence of partial or complete thrombosis is apparent on initial imaging studies, then angiographic confirmation is recommended. Hepatopulmonary syndrome (hypoxemia related to cirrhosis) occurs occasionally and usually subsides following transplantation. Significant pulmonary hypertension, on the other hand, precludes transplantation since cardiac deterioration following engraftment inevitably occurs and is usually fatal. **Patients who are HIV positive or who have psychiatric diseases such as depression and psychosis are not suitable candidates**. Patients with a remote (greater than 5 years) history of malignancy in a nonhepatic site may be considered for liver transplantation.
(bolding is mine) There’s tons more info at [http://www.livertransplant.org](http://www.livertransplant.org) , which I’d recommend looking into.
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### Author:  [@DMark](https://boards.straightdope.com/u/DMark)
#### Post date: [December 5, 2001, 9:11pm UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/4 "2001-12-05T21:11:26Z")
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> \*Originally posted by peepthis \*
> \*\*You know that straight people can get AIDS too, right? \*\*
Yes, I do.
That is why I asked if this is a NATIONAL policy (HIV + = no liver transplants regardless of who you are) or if this is a doctor who does not wish to submit a gay man’s name onto the national list.
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### Author:  [@odd-socks](https://boards.straightdope.com/u/odd-socks)
#### Post date: [December 5, 2001, 9:32pm UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/5 "2001-12-05T21:32:27Z")
I have no knowledge of the medical aspect of this, or even of the ramifications with regards to US law and medical practices, so with that disclaimer in mind, I’m still going to comment. [wonders if I need a flame suit? ;)]
Logically, I can understand why a person should be refused a transplant/treatment if their body has failed to such a degree that the success rate of the operation is considered to be low, but then again, aren’t many patients in a dire state anyway? Also, if this person is relatively healthy now, wouldn’t it be better to try and improve quality of life? On another level, to me at least, it just seems intrinsically wrong to refuse treatment/transplant options.
Also, a question: why would someone with depression be refused a transplant?
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### Author:  [@ChoosyChipsAndCeilingWhacks](https://boards.straightdope.com/u/ChoosyChipsAndCeilingWhacks)
#### Post date: [December 5, 2001, 10:05pm UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/6 "2001-12-05T22:05:21Z")
> [@](#):
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> \*Originally posted by carodin \*
> \*\*Also, a question: why would someone with depression be refused a transplant? \*\*
I was wondering that too. Seems odd.
There was a recent story here in MA about a woman who was HIV + and needed a liver transplant. IIRC, her insurance refused to pay for the transplant because of her HIV. However, she raised enough money to pay for it and I believe was eligible for a donor. I’m searching right now to find something about it. Anyone else have a clue about what happened to her?
-L
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### Author:  [@ChoosyChipsAndCeilingWhacks](https://boards.straightdope.com/u/ChoosyChipsAndCeilingWhacks)
#### Post date: [December 5, 2001, 10:12pm UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/7 "2001-12-05T22:12:00Z")
But I found some information about how they treat HIV + patients who need transplants in Massachusetts:
> **[Retired Site | PBS](https://www.pbs.org/retired-site/)**
>
> This Content is No Longer Available
[http://organtx.org/hivtx.htm](http://organtx.org/hivtx.htm)
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### Author:  [@mancunian](https://boards.straightdope.com/u/mancunian)
#### Post date: [December 5, 2001, 10:12pm UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/8 "2001-12-05T22:12:13Z")
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> \*Originally posted by DMark \*
> \*\*…the HIV is even undetectable. Other than his liver problems, he would be in perfect health.
> \*\*
The HIV is undetectable eh? Well how does any know he got it? Liver problems, I think not. No he’s been tested, it’s been detected, so he’s got it. Yup, and the late great Kurt Kobain would be in perfect health too, if it wasn’t for that death problem.
Why won’t they operate, well he has a limited lifespan (well about 20 years) when kids may need the same liver, and the doctors would be putting themselves at risk.
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### Author:  [@Mighty\_Maximino](https://boards.straightdope.com/u/Mighty_Maximino)
#### Post date: [December 5, 2001, 10:22pm UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/9 "2001-12-05T22:22:30Z")
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> \*Originally posted by SexyWriter \*
> I was wondering that too. Seems odd.
Well, I can’t think of anything worse for an HIV positive individual than to have to take powerful immunosuppressants to avoid organ rejection. Probably it would be very hard to avoid deadly infections even while taking other medications.
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### Author:  [@Otto](https://boards.straightdope.com/u/Otto)
#### Post date: [December 5, 2001, 11:03pm UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/10 "2001-12-05T23:03:43Z")
> [@](#):
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> Also, a question: why would someone with depression be refused a transplant?
WAG, higher suicide risk, thus wasting an organ?
I recall reading in Newsweek several months ago about Larry Kramer needing a liver transplant and being unable to find a transplant program willing to accept him. [This article](http://www.aegis.com/news/bar/2001/BR010805.html) indicates that he has since been accepted by the University of Pittsburgh Medical Center and discusses the implications for other HIV+ transplant candidates of both a successful and an unsuccessful transplant for Kramer.
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### Author:  [@Moirai](https://boards.straightdope.com/u/Moirai)
#### Post date: [December 5, 2001, 11:21pm UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/11 "2001-12-05T23:21:40Z")
> [@](#):
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> \*Originally posted by mancunian \*
> \*\*
>
> > [@](#):
> >
> > \*Originally posted by DMark \*
> > \*\*…the HIV is even undetectable. Other than his liver problems, he would be in perfect health.
> > \*\*
>
> The HIV is undetectable eh? Well how does any know he got it? Liver problems, I think not. No he’s been tested, it’s been detected, so he’s got it. Yup, and the late great Kurt Kobain would be in perfect health too, if it wasn’t for that death problem.\*\*
Um, I think that’s a medical thing, having to do with the levels of the virus present in one’s system. It does not mean you don’t have HIV.
\*\*
> [@](#):
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> Why won’t they operate, well he has a limited lifespan (well about 20 years) when kids may need the same liver, and the doctors would be putting themselves at risk. \*\*
Wrong again, I’m afraid. Unless Mickey Mantle only got his liver because he was a star. Plenty of older people get liver transplants. I don’t have a cite, but I would guess that it’s mostly older folks whose organs fail, for whatever reason.
I had heard that hep C can keep you off the list, but I hadn’t heard about HIV. It makes sense, I guess, if HIV can cause severe liver damage. It makes sense that if you have any disease which attacks the liver, it would be a waste to give you a fresh one.
Of course, alcoholics are given liver transplants, but that’s another thread, I’m sure!
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### Author:  [@odd-socks](https://boards.straightdope.com/u/odd-socks)
#### Post date: [December 5, 2001, 11:57pm UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/12 "2001-12-05T23:57:11Z")
**SexyWriter**
thanks for the links.
**Mancunian** said:
“…Why won’t they operate, well he has a limited lifespan (well about 20 years) when kids may need the same liver, and the doctors would be putting themselves at risk…”
I understand what you mean, but don’t doctors and nurses put themselves at risk daily, and not necessarily from the risk of HIV infection?
Also, to pick up a point that **EJsGirl** alluded to in relation to alcoholics needing transplants; similarly smoker’s and drug users? If we decided who is more worthy of treatment/transplants, where will that take us? Deciding that the elderly shouldn’t be treated because they’ve already had a _good innings_ as it were? Do we decide that criminals should not receive treatment?
**Mighty Maximino**
on the drug aspect: understood, thanks.
**Otto**
In terms of the suicide risk being higher for depressed people - well, possibly (I don’t have the figures to hand) but still, not all depressed people will commit suicide. Also, it seems likely to me that a person who is say, chronically ill and who needs a transplant/treatment, may very well become depressed because of their condition. If they are then refused treatment because of depression, it doesn’t seem quite fair, does it?
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### Author:  [@Smeghead](https://boards.straightdope.com/u/Smeghead)
#### Post date: [December 6, 2001, 12:10am UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/13 "2001-12-06T00:10:08Z")
> [@](#):
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> \*Originally posted by Mighty Maximino \*
> \*\*
>
> > [@](#):
> >
> > \*Originally posted by SexyWriter \*
> > I was wondering that too. Seems odd.
>
> Well, I can’t think of anything worse for an HIV positive individual than to have to take powerful immunosuppressants to avoid organ rejection. Probably it would be very hard to avoid deadly infections even while taking other medications. \*\*
I’m thinking this has got to be the main reason. When you have a transplant, you have to take drugs that basically all but shut down your immune system for the rest of your life. In an HIV patient, this would give the virus a field day. I’d suspect that they’d have a better chance of living without the liver transplant, even if they needed one.
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### Author:  [@Houlihan](https://boards.straightdope.com/u/Houlihan)
#### Post date: [December 6, 2001, 12:18am UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/14 "2001-12-06T00:18:46Z")
> [@](#):
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> \*Originally posted by Smeghead \*
> \*\*I’m thinking this has got to be the main reason. When you have a transplant, you have to take drugs that basically all but shut down your immune system for the rest of your life. In an HIV patient, this would give the virus a field day. I’d suspect that they’d have a better chance of living without the liver transplant, even if they needed one. \*\*
IANAD, but this makes a lot of sense. I had a family friend who got a kidney transplant, and while on the immunosuppressants, contracted a rare form of tuberculosis that unfornately killed her within a matter of weeks.
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### Author:  [@ejrn](https://boards.straightdope.com/u/ejrn)
#### Post date: [December 6, 2001, 12:35am UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/15 "2001-12-06T00:35:04Z")
**Mickey Mantle** only got his liver because he wasa star!!!
The general rule is that alcoholics and drug addicts are appropriate for liver transplants if they have been sober for a minimum of two years. Mickey did **not** meet the criteria.
I bitched about this, at the time, to a GI specialist friend. He was not upset about it. He explained that they play fast and loose with the criteria for celebrities because celrbrity transplants generate publicity. This publicity causes a temporary rise in the number of organ donations which is felt to more than offset the possibly “wasted” organ.
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### Author:  [@Lockz](https://boards.straightdope.com/u/Lockz)
#### Post date: [December 6, 2001, 2:38am UTC](https://boards.straightdope.com/t/hiv-ineligible-for-liver-transplant/97097/16 "2001-12-06T02:38:20Z")
> [@](#):
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> \*Originally posted by EJsGirl \*
> **I had heard that hep C can keep you off the list, but I hadn’t heard about HIV.**
I live in Canada, so I don’t know how much of a diffrence it makes. I have met people with Hep C that have had liver transplants. Don’t know how it applies to the country you live in.