Legal Information

What is the relevant law that needs to be amended?

The relevant law is the National Organ Transplant Act (NOTA), which prohibits the recovery of organs from donors "infected with the etiologic agent for acquired immune deficiency syndrome" (Public Law 100-607).[1] The wording of NOTA (not referring specifically to HIV) reflects the profound lack of knowledge about this disease during the time it was written.

When was the ban enacted?

The National Organ Transplant Act 1984 was amended in 1988 to prevent the recovery of organs from donors infected with the human immodeficiency virus (HIV). At that time, the amendment may have made sense, but it is now medically outdated. The language of the law reflects the intense atmosphere of fear that accompanied the discovery of AIDS, as little was known at the time about the etiology of this rapidly spreading disease. In fact, as reflected in the language of the current statute, the human immunodeficiency virus (HIV) had not even yet been identified as the cause of AIDS. Notably, the same health omnibus bill banning the transplantation of organs that might transmit AIDS also provided funding for AIDS research, directed the Centers for Disease Control and Prevention (CDC) to study the epidemiology of AIDS, and began national education efforts on AIDS prevention.

Can this be done state-by-state?

No. The National Organ Transplant Act is a federal law. Even if a state changed its law to allow for these type of transplants, because of the supremacy clause in the Constitution, the federal law would override the state law. This is what happened in Illinois in 2004, but because of the federal law, no such transplant were able to be performed.

What are the costs of reversing the law?

Actually, reversing this law would save money. Since the care of patients with kidney failure in the United States is covered as part of the Medicare End Stage Renal Disease Program (which consumes 6.6% (>$20 billion) of the entire Medicare budget), these transplants will save Medicare approximately $500,000 per patient.[2] In the setting of health care and budget crises, transplantation—in addition to saving lives—makes economic sense by saving taxpayers money.

References

  1. 42 USC § 274 - Organ procurement and transplantation network, Legal Information Institute, Cornell University Law School.
  2. US Renal Data System, USRDS 2011 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2011.