AN HIV patient is to receive a liver transplant for the first time in Scotland following breakthroughs in the treatment of the condition, writes Tara Womersley.

Doctors at the Scottish liver transplant unit in Edinburgh made the decision after combination drug therapy dramatically increased the life expectancy of people infected with the virus.

Liver disease is now the most common cause of death for HIV patients also infected with hepatitis B or C.

The patient, who has not been named, is among 23 on a waiting list to receive a donor organ. It is not known whether they have hepatitis.

John Forsythe, a transplant surgeon at the unit, said all prospective recipients had to have a 50% chance of surviving five years after the operation and that the HIV patient met the criterion. “This is a reasonable compromise for people who have a life-threatening disease when you are looking at the best use of a very scarce resource,” he said.

Dr John O’Grady, a hepatologist involved in drawing up the new guidelines, added: “The fact that we are now carrying out operations on HIV patients is testimony to the efficacy of the combination drug treatment that they are using.

“Sadly, there are fewer organ donors than we need and donation rates across the UK are below those of other countries.”

However, concerns have been raised about the long-term benefits because of complications that can arise when HIV patients are also infected with hepatitis C.

Last night Margaret Watt, chairman of Scotland Patients Association, expressed reservations about the decision.

“There are so many people who need transplants, but not enough organs,” she said. “We would need to make sure this was carefully monitored.

“Everyone in need of a transplant should get it but only if they will have a better quality of life. If they do not, then the organs should go to someone else.”

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