American surgeons are becoming more willing to perform transplant operations for AIDS patients. The improving health and greater life expectancy of AIDS patients have meant that the greatest threat to their lives may be their failing organs rather than their disease. A federal government health agency and researchers at 17 US transplant centres have now launched a five-year study of 275 patients to examine what happens when HIV patients receive new livers or kidneys. About 100 such operations have already been done, and health insurance companies often agree to pay for them.

In the past transplant surgeons were reluctant to deal with HIV- infected patients because they felt that scarce organs should be given to people who would live longer. They also felt that medicines to suppress rejection might actually hasten the death of HIV patients. There were also fears that medical staff might become infected. However, with the development of better AIDS drugs, and increasing pressure from AIDS activists, doctors are beginning to change their minds. “It’s such backward thinking for people to argue that HIV patients shouldn’t be transplanted,” says Dr John Fung, of the University of Pittsburgh, whose hospital is the leader in HIV transplants.