As VA Hospitals Refuse to Even Consider Patients with HIV for Organ Transplants, Lambda Legal Presses Dept. of Veteran Affairs for Nationwide Policy Change

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Case of Iowa man who can't even be evaluated for transplant shows how "VA's misguided policy is putting the lives of national heroes in jeopardy," Lambda Legal says
April 27, 2004

(Washington, D.C, Tuesday, April 27, 2004) - Lambda Legal today urged the U.S. Department of Veterans Affairs to stop local VA hospitals from refusing to even evaluate patients with HIV for organ transplants, saying the current policy may cost an Iowa man his life as the VA refuses to consider him for a liver transplant because he has HIV.

Lambda Legal, which represents the Iowa patient, is asking the Department of Veterans Affairs to immediately issue a clear policy that requires VA hospitals to assess each individual patient’s health, rather than just HIV status, when considering potential transplant recipients.

“VA hospitals are ignoring good medicine and sound science, and the Department of Veterans Affairs has a moral and legal obligation to step in,” said Jonathan Givner, AIDS Project Staff Attorney at Lambda Legal. “The VA’s misguided policy is putting the lives of national heroes in jeopardy. In the last eight years since the advent of better treatments for people with HIV, the medical community nationwide has learned a great deal about organ transplants, and VA hospitals owe it to our nation’s veterans to follow suit.”

Last week, Lambda Legal filed a complaint w ith the Iowa City Department of Veterans Affairs Medical Center on behalf of Gideon Green. Green is a 57-year-old Vietnam War veteran whom the VA hospital won’t even consider for a liver transplant because he has HIV. Green suffers from end-stage liver disease and his physicians have suggested that he may be a candidate for a liver transplant - but since the hospital won’t allow him to be considered for a transplant, his health status and the chances for survival with a transplant cannot be evaluated fully.

In today's letters to the Secretary of Veterans Affairs, Under Secretary for Health, and VA’s Office of Public Health and Environmental Hazards, Lambda Legal asks for clarity with a national policy concerning organ transplantation for people with HIV. The letter states: "For individuals like our client, the VA's lack of uniform, medically justifiable policy may have fatal consequences. Considering that approximately one-third of people with HIV in the United States are co-infected with hepatitis C, which can cause severe end-stage liver disease, the VA's practice like has an astounding impact on a large number of HIV-positive veterans." VA hospitals provide a range of services to more than 20,000 veterans with HIV, and the VA opened its Center of HIV Research Resources at Palo Alto Health Care System in California in 2001. When the center opened, its director, Dr. Mark Holidniy, said, “Although HIV-infected veterans receive quality care with VA, the creation of this center will expedite access to cutting edge HIV treatments, therapies and strategies.”

In its appeal letters to the Iowa City hospital and the Dept. of Veterans Affairs, Lambda Legal cites mainstream medical journals that show “no evidence of poorer survival among otherwise healthy HIV-positive patients.” The articles conclude that “transplantation in HIV-positive patients should … not be considered experimental.”

“Providing transplants to people with HIV is no longer cutting edge. It is the norm,” Givner said. “Given the medical facts and the health of our client, there’s no question that this transplant assessment should be granted as quickly as possible. By continuing to refuse to evaluate him for a transplant, the VA could cost Mr. Green his life.”

Last year, in two separate cases, Lambda Legal persuaded a state Medicaid program and one of the nation’s largest HMO’s to overturn decisions that prevented people with HIV from receiving organ transplants. John Carl was denied a kidney transplant by Kaiser Permanente in Colorado, but the HMO reversed course in light of a range of scientific data and the client’s personal health history and experience. The second reversal was on behalf of William Jean Gough, who was denied a liver transplant by Pennsylvania’s Medicaid program. Again, the decision was overturned once medical data concerning transplants for patients with HIV was considered.

Green tested positive for HIV in 1995 but does not experience any significant symptoms of HIV. The hepatitis has caused Green to reach end-stage liver disease. Currently, Green receives VA disability benefits because of his end-stage liver disease.

According to Lambda Legal, people with HIV are sometimes blocked from being considered for transplants, even though medical and scientific evidence makes it clear that they should be evaluated on a case-by-case basis like any other transplant candidates.

Givner is handling the case, In Matter of Gideon Green, for Lambda Legal.


About Lambda Legal’s AIDS Project
Lambda Legal was founded in 1973 to advance the civil rights of lesbian, gay, bisexual and transgendered people, and began working on behalf of people with HIV and AIDS at the onset of the epidemic in the 1980s. Lambda Legal litigated the first AIDS discrimination case in the nation in 1983, and later successfully forced hospitals to treat people with HIV and pushed prescription drug companies to lower the cost of HIV and AIDS treatments. Lambda Legal’s AIDS Project has won critical victories on behalf of people with HIV and AIDS to be treated equally and with dignity in employment, medical services, public accommodations, parenting and other areas of life. Last week, Lambda Legal announced a record $600,000 settlement between its client, Matthew Cusick, and Cirque du Soleil that ended an HIV discrimination complaint filed on behalf of Cusick. Cusick was fired last year because he has HIV. The settlement ended a nationwide campaign and a federal disability complaint filed by Lambda Legal. Contact: Fred Shank, 212/809-8585 ext. 267; Cell: 917/691-5412



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