BILL ANALYSIS Ó
SB 1408
Page 1
(Without Reference to File)
SENATE THIRD READING
SB
1408 (Allen)
As Amended May 26, 2016
2/3 vote. Urgency
SENATE VOTE: 34-0
------------------------------------------------------------------
|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Health |15-0 |Wood, Maienschein, | |
| | |Gordon, Burke, | |
| | |Campos, Chiu, Gomez, | |
| | |Lackey, Nazarian, | |
| | |Olsen, Jones, | |
| | |Rodriguez, Santiago, | |
| | |Thurmond, Waldron | |
| | | | |
| | | | |
------------------------------------------------------------------
SB 1408
Page 2
SUMMARY: Allows for the transplantation of organs into the body
of a person when the donor of the organ has human
immunodeficiency virus (HIV). Contains an urgency clause to
ensure that the provisions of this bill go into immediate effect
upon enactment. Specifically, this bill:
1)Deletes the prohibition in existing law on the transplantation
of tissue from a donor with HIV and instead permits such
transplantation if the physician and surgeon performing the
transplantation has ensured that the organ from an individual
who has been found reactive to HIV may be transplanted only
into an individual who satisfies both of the following:
a) The individual has been found reactive for HIV before
receiving the organ; and,
b) The individual is either participating in clinical
research approved by an institutional review board pursuant
to federal requirements, or if the United States (U.S.)
Secretary of Health and Human Services determines that
participation in this clinical research is no longer
warranted as a requirement for transplants, as specified.
2)Exempts the donation of organs from HIV positive individuals
from specified criminal penalties.
3)Defines "organ," for purposes of this bill, as a human kidney,
liver, heart, lung, pancreas, or intestine (including the
esophagus, stomach, small or large intestine, or any portion
of the gastrointestinal tract), or vascularized composite
allograft, and associated blood vessels recovered from an
organ donor during the recovery of such organ.
SB 1408
Page 3
4)Provides that the Medical Board of California will not take
disciplinary action against a licensee who performs organ
transplants in compliance with this bill.
FISCAL EFFECT: None.
COMMENTS: According to the author this bill would greatly
improve the life expectancies of people living with HIV who need
organ transplants by removing California's prohibition on
donating organs while HIV-positive. The author notes that under
current state law, it is illegal for an HIV-positive person to
donate organs under any circumstance. The author points out
this law was enacted nearly 20 years ago at a time when very
little was known about HIV and acquired immune deficiency
syndrome (AIDS), and that recent research made possible by the
passage of the federal HIV Organ Policy Equity (HOPE) Act of
2013 found that organ donations from HIV-positive donors to
HIV-positive recipients are safe. The author continues, major
advances in the treatment of HIV and AIDS mean that HIV-positive
individuals are living longer, and like other older Americans,
they too are developing medical conditions that require organ
transplants. However, the number of individuals in need of
organ transplants far exceeds the availability of healthy organs
and increasing the number of eligible donors for HIV-positive
individuals will save lives.
According to an article published in September of 1987 in the
journal Transfusion, an estimated 12,000 people in the U.S.
contracted HIV from blood transfusions between 1978 and 1984,
leaving the public fearful. In response, the U.S. passed a ban
on organ collection from HIV-positive donors in 1988. However,
by the late 1990s screening procedures for HIV had become
accurate enough to eliminate this worry, and simultaneously, the
development of effective antiretroviral drugs meant that
HIV-infected people could expect to live to a relatively old
SB 1408
Page 4
age, and also develop the disorders that come with advancing
age.
In 1999 the University of California, San Francisco (UCSF)
transplant surgeon, Dr. Peter Stock received a $3 million grant
from the state of California for a pilot study transplanting
uninfected livers and kidneys into HIV-positive recipients. The
37 patients appeared to do well overall and were only slightly
more likely to reject organs than HIV-negative recipients were.
In 2004, Dr. Stock and his colleagues published an article in
the New England Journal of Medicine, "Outcomes of Kidney
Transplantation in HIV-Infected Recipients." The article
discussed the results of another trial in which 150 patients
underwent kidney transplants between November 2003 and June
2009. According to the article, the trial showed that kidney
transplantation appears to be a feasible therapy in carefully
selected HIV-infected patients.
On November 21, 2013, President Obama signed into law the HOPE
Act, which allowed for scientists to carry out research into
organ donations from one person with HIV to another.
A March 30, 2016, article in the Los Angeles Times announced the
first organ transplantation from a deceased HIV-positive donor
to two HIV-positive recipients in the U.S., performed by
surgeons at Johns Hopkins University Medical Center in Baltimore
Maryland. The surgeons who performed the transplants at Johns
Hopkins conducted research, published in The American Journal of
Transplantation in 2011 that each year 500 to 600 HIV-positive
people will die under circumstances that would make their organs
available for transplant, which has the potential to save about
1,000 lives each year.
Currently there are four hospitals who have met the criteria to
participate in HOPE Act transplant research: Johns Hopkins
Hospital in Baltimore, Maryland (liver and kidney programs),
Hahnemann University Hospital in Philadelphia, Pennsylvania
(liver and kidney programs), Mount Sinai Medical Center in New
York, New York (liver and kidney programs), and UCSF Medical
SB 1408
Page 5
Center, San Francisco, California (liver {deceased and living
donor} and kidney {deceased donor} programs).
According to the Organ Procurement and Transplantation Network
there are currently 123,288 people in the U.S. waiting for a
life-saving organ transplant, and every 10 minutes another
person is added to that list. Each day an average of 22
patients die waiting for an organ. According to the United
Network for Organ Sharing, approximately 23,000 Californians are
on the waiting list for an organ transplant.
Analysis Prepared by: Lara Flynn / HEALTH /
(916) 319-2097 FN: 0003057