Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.

Reuters NewMedia - Wednesday, June 04, 2003

The patient, Robert Zackin of the Harvard School, has now been alive and well for more than two years after he was near death, according to a report released on Wednesday in the New England Journal of Medicine.

His heart had been failing from an apparent reaction to the medicine he was taking as part of his illness.

The case reflects the new reality among people infected with HIV, the AIDS virus. The newest drugs can be so good at keeping the deadly immunity disease in check that people with the illness are now candidates for organ transplants.

"Liver and kidney transplants showed it was feasible," immunologist Leonard Calabrese of the Cleveland Clinic told Reuters. "We've gone from giving people a pat on the back and watching them die 20 years ago, to being able to treat infections, to now having the prospect of transplanting a vital organ such as a heart."

Zackin, who coauthored the Journal article, became infected with HIV in 1986 and was diagnosed in 1992. Side effects from the Gilead Sciences Inc. GILD.O anti-cancer drug liposomal daunorubicin apparently led to his heart problems. At one point, in April 1994, his CD4 count -- which gauges the health of an immune system -- was down to zero. But a new generation of AIDS drugs helped rebuild his immunity.

By 2000 he was looking for a heart transplant. He was turned down at other centers until the Cleveland Clinic decided to accept him in January 2001, in part because his HIV infection was under control.

By then, his heart was so weak, a balloon pump had to be implanted in his aorta to keep him alive. Three weeks later, he got his transplant.

Zackin has to have regular transfusions, but is now working full time and exercising regularly.

"It's been two years with a high quality of life. That's a lot to get out of a transplant," Calabrese said.

Calabrese said he expects the New England Journal report to spark debate on whether people with HIV should be eligible for a transplant.

But that is not an issue at the Cleveland Clinic. "Twenty five years ago, people would have the same thing about a diabetic," he said. Diabetes is no longer a bar to transplantation.

The real question, Calabrese said, is whether the recipient can get good use from their new organ. Transplant centers do not, for example, give lungs to current smokers or livers to heavy drinkers.

030604
RE030608

Always watch for outdated information. This article first appeared in 2003. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2003. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .