In response to Lambda Legal Action, U.S. Dept. of Veterans Affairs Will Now Evaluate Patients with HIV for Organ Transplants, But Won't Perform the Life-Saving Procedure

(Washington, D.C, Thursday, April 29, 2004) - With the U.S. Dept. of Veterans Affairs changing course and saying late last night that local VA hospitals nationwide should assess patients with HIV for organ transplants, Lambda Legal today pressed the federal agency to take immediate action and end its discriminatory policy so veterans with urgent health needs are not left in limbo.

The Dept. of Veterans Affairs said VA hospitals should evaluate people with HIV to see if they’re suitable for transplants — but said the VA will not perform the life-saving transplants. The agency also has not indicated whether patients with HIV can begin having access to pre-transplant treatment or be placed on waiting lists for organs while a national policy is developed. The Dept. of Veterans Affairs also hasn’t given a timetable for developing a final policy — even though Lambda Legal said the life-saving nature of organ transplants requires immediate action.

“The Dept. of Veterans Affairs has taken a step in the right direction, but this policy shift still leaves in place a practice that discriminates against veterans with HIV on the basis of antiquated science — all while veterans’ lives hang in the balance,” said Jonathan Givner, AIDS Project Staff Attorney at Lambda Legal. “The science is clear that HIV is not a limitation on survival after kidney and liver transplant. While the bureaucracy of Veterans Affairs waits and debates the obvious, the nation’s most credible medical experts and journals have already concluded that transplants should be available to people with HIV.”

“Today, we call on the Dept. of Veterans Affairs to immediately clarify whether patients with HIV will have access to lifesaving treatment and can be placed on waiting lists for organs. We also call on the Dept. of Veterans Affairs to release a timetable explaining when VA will adopt a policy that does not discriminate against veterans with HIV,” Givner said.

Medical journals that have published findings showing that HIV is not a limitation on organ transplants include New England Journal of Medicine, Journal of Infectious Diseases, Transplantation, Clinical Transplantation, Journal of AIDS, Liver Transplantation, Current Opinion in Organ Transplantation, Transplantation Proceedings, and Organ Transplantation.

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. Earlier this week, the Iowa City hospital reversed course and agreed to consider Green for a transplant, just days after the hospital’s director, Gary L. Wilkinson, had sent a letter to U.S. Congressmen Lane Evans rejecting Green because he has HIV.

In a letter sent earlier this week 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.”

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 after Lambda Legal presented a range of scientific data and information regarding the client’s personal health history and experience. Lambda Legal won a second reversal on behalf of William Jean Gough, who was denied a liver transplant by Pennsylvania’s Medicaid program. In response to Lambda Legal’s appeal, an administrative law judge overturned the decision 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.