[procaare] Doctors hail AIDS patient's heart transplant.

[AEGIS <procaare@healthnet.org>]

Doctors hail AIDS patient's heart transplant.
- [AEGiS] Reuters NewMedia, ( 06.04.03).
***************************

BOSTON, June 4 (Reuters) - U.S. doctors say the first long-term survival after a heart
transplant in a person with AIDS offers new hope to patients.

The patient, Robert Zackin of the Harvard School, has now been alive and well for more
than two years after he was near death, according to a report released on Wednesday in the
New England Journal of Medicine.

His heart had been failing from an apparent reaction to the medicine he was taking as part
of his illness.

The case reflects the new reality among people infected with HIV, the AIDS virus. The
newest drugs can be so good at keeping the deadly immunity disease in check that people
with the illness are now candidates for organ transplants.

"Liver and kidney transplants showed it was feasible," immunologist Leonard Calabrese of
the Cleveland Clinic told Reuters. "We've gone from giving people a pat on the back and
watching them die 20 years ago, to being able to treat infections, to now having the
prospect of transplanting a vital organ such as a heart."

Zackin, who coauthored the Journal article, became infected with HIV in 1986 and was
diagnosed in 1992. Side effects from the Gilead Sciences Inc. GILD.O anti-cancer drug
liposomal daunorubicin apparently led to his heart problems. At one point, in April 1994,
his CD4 count -- which gauges the health of an immune system -- was down to zero. But a
new generation of AIDS drugs helped rebuild his immunity.

By 2000 he was looking for a heart transplant. He was turned down at other centers until
the Cleveland Clinic decided to accept him in January 2001, in part because his HIV
infection was under control.

By then, his heart was so weak, a balloon pump had to be implanted in his aorta to keep
him alive. Three weeks later, he got his transplant.

Zackin has to have regular transfusions, but is now working full time and exercising
regularly.

"It's been two years with a high quality of life. That's a lot to get out of a
transplant," Calabrese said.

Calabrese said he expects the New England Journal report to spark debate on whether people
with HIV should be eligible for a transplant.

But that is not an issue at the Cleveland Clinic. "Twenty five years ago, people would
have the same thing about a diabetic," he said. Diabetes is no longer a bar to
transplantation.

The real question, Calabrese said, is whether the recipient can get good use from their
new organ. Transplant centers do not, for example, give lungs to current smokers or livers
to heavy drinkers.

Copyright (c) 2003 - Reuters, Ltd. All rights reserved.

Source: AEGiS:  http://ww2.aegis.org/news/re/2003/RE030608.html
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