In world first, HIV-positive woman donates kidney to HIV-positive recipient

Nina Martinez donated a kidney in a historic surgery that was performed Monday.   Photo courtesy of Sarah Marie Mayo

(CNN)An Atlanta woman became the first living HIV-positive kidney donor in the world on Monday when surgeons at Johns Hopkins Medicine in Baltimore transferred her organ to a recipient who is also HIV-positive, according to a statement from the medical center. Both the donor and the recipient, who wishes to remain anonymous, are doing well.

Nina Martinez, who has HIV, donated a kidney to an HIV-positive recipient.  Photo courtesy of Michele Rhee
Nina Martinez, a 36-year-old public health consultant, acquired HIV as a 6-week-old in 1983, when she received a blood transfusion in the years before blood banks began routine testing for the virus. HIV damages the immune system and interferes with the body's ability to fight the organisms that cause disease.
    Despite her illness, Martinez's enduring spirit is audible.
    "I really want people to reconsider what living with HIV means," she said from her hospital bed two days after her operation. "If anyone is proof that you can live a lifetime with HIV, that is myself. I've been living with HIV for 35 years -- pretty much the length of the epidemic in the United States."
    Dr. Dorry Segev, a professor at Johns Hopkins University School of Medicine and the surgeon who performed Martinez's operation, praised her bravery and said that the historic surgery is "really a celebration of HIV [medical] care and its evolution."

    Giving 'HOPE' to people living with HIV

    Until 2013, the United States did not permit HIV-positive organ donations, Segev said: "I was watching people with HIV die on our transplant list, and I was watching us have to decline every single potential donor, whether deceased or living, just because they had HIV."
    No one considered HIV donor transplants feasible based on two concerns: The virus itself can injure the kidney, and antiretrovirals -- the drugs that control HIV -- are toxic to the kidney. "We had to show that certain people with HIV could be healthy enough to be a kidney donor and to live with only one kidney," Segev said.
    As people live longer with HIV, they are experiencing more kidney failure related to high blood pressure, diabetes and heart disease, Martinez explained. "Because people living with HIV are disproportionately impacted by the length of the donor wait list, if you are living with HIV, you are nearly twice as likely to pass away while waiting for a kidney," she said.
    The passage of the HIV Organ Policy Equity (HOPE) Act in November 2013 allowed researchers to conduct studies of organ transplants from HIV-positive donors to HIV-positive recipients. The act does not give priority status to HIV-positive patients but provides a donor pool specifically for people living with HIV. Individual states that had passed laws restricting donations from people with HIV are working quickly to match federal legislation, said Segev, who help draft the HOPE Act.