BILL ANALYSIS                                                                                                                                                                                                    



                                                                    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


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          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


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          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


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          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  








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          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