Iowa VA Hospital Backs Down, Will Consider Patient with HIV for Organ Transplant; Lambda Legal Says Dep't of Veteran Affairs Must Follow Suit with National Policy

(Washington, D.C, Wednesday, April 28, 2004) - Lambda Legal today said that an Iowa Veterans Affairs hospital’s decision to reverse course and consider a man with HIV for a liver transplant puts new pressure on the federal Dep’t of Veterans Affairs to require consistent transplant practices at VA hospitals nationwide.

“The Iowa City VA hospital is fulfilling its legal and ethical obligation to patients - but nationally, the VA is not. Until the U.S. Department of Veterans Affairs makes it clear that an HIV-litmus test is bad practice, the 20,000 patients with HIV that are treated at VA hospitals nationwide will receive sub-standard care,” 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, medical experts nationwide have unanimously concluded that HIV is not a limitation on survival after transplants, and VA hospitals owe it to our nation’s veterans to follow suit.”

Lambda Legal, which represents the Iowa patient, asked the Dept. of Veterans Affairs yesterday 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. The Department of Veterans Affairs has not formally responded to the request. A spokesperson for the department said yesterday that officials are reviewing the policy but that any changes won’t come soon. “It’s not like it’s going to be tomorrow,” Department of Veterans Affairs spokesperson Jo Schuda told the Associated Press.

Lambda Legal today pressed the federal agency to move more quickly. “These patients don’t have time to wait,” Givner said. “This is truly a matter of life and death for many veterans with HIV. They deserve more than a bureaucratic brush-off from the federal government.”

Last week, Lambda Legal filed a complaint with 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 wouldn’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 was never able to even be considered.

In letters to the U.S. Secretary of Veterans Affairs, Under Secretary for Health, and VA’s Office of Public Health and Environmental Hazards in Washington, D.C., Lambda Legal asked for 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.”

“Providing transplants to people with HIV is no longer cutting edge. It is the norm,” Givner said.

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.

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