Researcher With AIDS Doing Well After Heart Transplant

A Harvard researcher diagnosed a decade ago with AIDS is alive and well two years after receiving a heart transplant at the Cleveland Clinic.

The first-of-its kind transplant, reported in the New England Journal of Medicine, is a further symbol of changing attitudes toward HIV patients, who until five years ago were generally viewed as ineligible for liver transplants.

With modern therapies, many HIV-positive patients now live for many years after diagnosis, and are increasingly being considered as candidates for scarce transplant organs.

The transplant patient, Dr. Robert Zackin, 39, a researcher at the Harvard School of Public Health, was infected with HIV in 1986 and diagnosed with AIDS in 1992.

Zackin also developed Kaposi's sarcoma, a type of cancer often found in AIDS patients, and underwent chemotherapy and a variety of other treatments.

In 2000, when it became clear his heart was failing, he started looking for a heart transplant, and was turned down by several hospitals before being accepted by the Cleveland Clinic.

Dr. Leonard H. Calabrese of the Cleveland Clinic Foundation said that earlier transplants involving HIV patients receiving new kidneys, and subsequently livers, had shown what was possible.

The National Institutes of Health currently is studying 150 kidney transplants and 125 liver transplants in HIV-infected individuals. So far, researchers report these transplants appear to be no less successful among AIDs patients than for other recipients.

"We've gone from giving people with HIV a pat on the back and watching them die to being able to treat infections, to now having the prospect of transplanting a vital organ such as a heart," Calabrese said.

Calabrese said he hoped the New England Journal article would lead to increased discussion on whether HIV-positive patients should be eligible for heart transplantation.

Other Sources: New England Journal of Medicine, Cleveland Clinic