Health Team

Duke performs first liver transplant on patient with HIV

Posted April 3, 2018 11:16 p.m. EDT

— The Hope Act of 2013 offered a new opportunity for lifesaving organ transplants for people living with HIV, and Duke Hospital recently had their first patient to benefit from the program.

Stan Boling, 61, of Knoxville, Tenn. was infected with Hepatitis B in 1976 and diagnosed with HIV in 1982. Eventually, medications helped him control his HIV, but by last summer, it was liver failure due to hepatitis that threatened his life.

“It was just going to be the end,” he said.

Last September, at Duke Hospital, Boling learned he could go on two transplant waiting lists, one for HIV negative donor livers and a second for HIV positive donors. The second list is where doctors found a match for Boling.

“The fact that it came three days before Christmas made it really special,” Boling said.

A team of Duke physicians carefully assessed Boling as a candidate for a transplant. Working in his favor was a strong record of good HIV control with medication.

“He’s been very compliant, and sort of almost like a poster child for liver transplant,” said Duke transplant surgeon Dr. Kadiyala Ravindra.

“It’s been a bit of a new pathway for us to be able to make a transplant available to folks for whom it might have been more challenging,” said Dr. Cameron Wolfe.

It was the Hope Act of 2013 that allowed major transplant centers like Duke to begin assessing patients like Boling for transplantation. Before the law was passed, it was illegal for people with HIV to become organ donors.

“Those organs, unfortunately, went into the trash,” said Dr. Carl Berg, director of liver transplantation at Duke Hospital.

Now, when a patient finds a suitable match from the HIV donor list, it helps more than just the recipient.

“When Stan is able to get an HIV positive organ, it frees up a potential donor that he was waiting for on the regular list,” Berg said.

At first, Boling wondered if he had enough energy to go through surgery, recovery and livelong management of his and the donor’s HIV.

“But I’m so glad I went through it because there is another side and I’m doing fine,” he said.

Duke Hospital is currently the only transplant center in the state with a program accepting HIV donor organs for transplant recipients, including kidneys from living donors with HIV.