Organ Donation and Homosexuals

Nurses General Nursing

Published

Hey everyone. I had a pt come into the ER in full cardiac arrest. Didn't make it. 56 yr old really sad. He had a life partner who was extremely distraught and actually signed in to get medication to calm down. Anyway, he specifically told us about his partner being an organ donor. Even the coroner who came and ruled this a cardiac death mentioned to make sure about organ donation.

I call kidney one go through all their ?s and what happened. Then I progress to the next level and another rep calls me back go through EVERYTHING all over. Finally I mentioned something about the pt's life partner and slap instantly this pt's rejected due to "high risk behavior."

Now from my understanding the thing probably of concern is transmitting aids even with the organs tested if just infected will not show up. I really think this couple was in a monogamous relationship. They had been together for over 5 years. The guy was probably much healthier and less riskier than some other organs donated. I can see that with anal sex you can cause tearing more and transmit aids and that is probably the high risk the criteria is for but is ther percentage that great to reject organs for donation? I heard people with tatoos are rejected for blood (I don't know about organ donation). Still even with this in mind I was still quite surprised. Especially it deemed "high risk behavior." Because that is not necesarilly so. I would think risky behavior is multiple sex partners and yes that is but that's with all groups.

I mentioned this to my friend and instantly she states it's like this because aids is "astronomical" in homosexual populations. Is that really so? I know she is against homosexuality very much and absolutely know that is in her mind as well but with anal sex there is more tearing and potential but does anybody know actual numbers from an acredited sorce? I know in the 80s aids was really pushed out there because it was found in the homosexual poplulation. I suppose I can look on a main aids site or gov type thing. I'm comming accross just random pages with no substance to back it.

Is this risk really that relavant? And should it be deemed "high risk." And one article I read type cast homosexuals in general so what about lesbians? I know donations have to be screened excessively but is this too much?

--broke my huge paragraph up hope it helps to read it!!

Specializes in Telemetry, OR, ICU.
It's not an exchange of fluids from a HOMOSEXUAL encounter- it's an exposure to fluids from an INFECTED individual during anal intercourse. The encounter could easily be (and frequently is) from a hetero encounter. Also, the statement about the risk of one encounter isn't true- the transmission rate after one encounter is actually quite low- the virus just isn't very hardy. Getting a needle stick from a Hep-C+ patient, on the other hand, is VERY risky.

And, for the record, the estimate I've been hearing is that 50% of americans with HIV don't know they have it. So, that would pretty much exclude anyone who has condomless sex with anyone else whose HIV status they don't know.

That would exclude a HUGE number of people.

On a side note; Active duty Soldiers are required to submit HIV blood draw every two years.

Specializes in M/S/Tele, Home Health, Gen ICU.

I know that I can't donate blood anymore since I lived in the UK and ate beef in the 1980's, I should imagine that I can't donate my organs too. it's a shame that otherwise healthy organs might go to waste, may be potential recipients could sign some kind of waiver so they could receive organs from people that are "high risk", but test negative, it might buy them a few more years.

This is just really, really sad. I really feel for his life partner. His life partner was trying to make some good out of a catastrophic situation in his life by carrying out his partners' last wishes, just to be denied by what I feel is a judgment call made by the donor rep. I see this as another slap in his face, too.

What about college blood drives? How about the story of the sorority that told it's members to donate no matter what (so they could get the Greek glory or whatever of having the most donate from their house). The email that was sent out to her fellow sorority sister said something like, "Did you get a tattoo last week? DON'T TELL THEM. You have a cold or are sick? Suck it up. We all do." By sending out this email she potentially affected so many people.

It's just so sad a certain group of people are disallowed to give due to "risky behavior."

I don't know what I'm trying to say here, but it's all just a dirty rotten shame. :madface:

Specializes in Oncology/Haemetology/HIV.

My understanding is that MSMs are not permitted to donate blood or marrow. Thus (given that you can test blood/marrow more comprehensively than organs - time is not as great an issue), I can see where the ban on donating organs is consistant.

Due to my medical history and transfusion history, I am not permitted to donate organs or blood, so you really can't chalk it up prejudice.

It seems like something to quibble over...each person's presumed risky behavior. But take into account the lawsuits over passing on contaminated tissue, and you can see the concern.

As far as nurses coming in contact with everything, we also have access to PPE. We also presumably(?) take greater care with our hygiene, than the public.

There is no one completely free of risks. But as someone that got transfused with blood, known later to be contaminated, I will never be permitted to donate anything....though I have always tested negative. And I can understand the concern.

Also think of this. Patients that have been treated for cancer (chemo/rad) are frequently not permitted to donate blood/most transplant organs. This despite that research has not seen any link with recipients having a higher risk of cancer and that the organs were not permanently affected by chemo.

OK, let me try to narrow down my thoughts.

It's just very sad that a person, regardless of sexual orientation, who is in a monogamous situation is not able to donate, whereas frequently they have blood drives on college campuses where students may be encouraged to lie about their behaviors in order to win a competition, and they are able to donate.

If we know beyond a shadow of a doubt that this person was in a monogamous relationship, could prove testing negative for all diseases in the last 6 months, why could s/he not be considered as a donor?

I should say that I understand the causes of HIV and Hep. It's just sad that a group of people are labeled automatically high risk for "risky behaviors" that may not exist in an individual. So many people could be helped by one person donating.

I guess that's what I was trying to say.

Specializes in Critical Care.
What about college blood drives? How about the story of the sorority that told it's members to donate no matter what (so they could get the Greek glory or whatever of having the most donate from their house). The email that was sent out to her fellow sorority sister said something like, "Did you get a tattoo last week? DON'T TELL THEM. You have a cold or are sick? Suck it up. We all do." By sending out this email she potentially affected so many people.

Most donation centers protect against peer pressure by having you fill out a confidential statement to 'use or don't use' your donation.

You STILL get credit, and the supply is protected against peer pressure donations.

~faith,

Timothy.

Specializes in Telemetry, OR, ICU.
OK, let me try to narrow down my thoughts.

It's just very sad that a person, regardless of sexual orientation, who is in a monogamous situation is not able to donate, whereas frequently they have blood drives on college campuses where students may be encouraged to lie about their behaviors in order to win a competition, and they are able to donate.

If we know beyond a shadow of a doubt that this person was in a monogamous relationship, could prove testing negative for all diseases in the last 6 months, why could s/he not be considered as a donor?

I should say that I understand the causes of HIV and Hep. It's just sad that a group of people are labeled automatically high risk for "risky behaviors" that may not exist in an individual. So many people could be helped by one person donating.

I guess that's what I was trying to say.

Monogamous relationship? Monogamy is the custom or condition of having only one mate during a period of time. So, two people in a monogamous relationship that practice [lack of a better word] anal sex certainly provide a shadow of doubt.

I think that the risk factors involved should be up to reciepient. People die waiting for transplants. If you were that person....in the end stage...still waiting for your number and match to come up...wouldn't you take what you could get and deal with the consequences later?

Why not let the pt. receiving the organ make the choice? Make it an educated choice. I have to believe that even an organ from an HIV + patient is better than no organ at all...

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

CG: We know not their (homosexuals') sexual practices, definately. Who can say for sure that hetero's don't engage in MUCH riskier behaviors??? Let's don't go there please.

And the point about health care workers then being extremely high risk, and therefore potentially ineligible is well-taken by me.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

I don't think's it's prejudice that motivates them, it's fear and some practicality.

I understand that as a gay man, I fall in a high risk category because you can't argue with facts. Gay men still make up the largest group of HIV carriers.

However, the fact remains that there are potentially millions of HIV negative men, engaging in safe sex, or no sex, or monogamous sex with another HIV negative partner that can't donate and to me that's bitterly disappointing.

Rapid HIV tests are becoming available. I hope that these can be used to remove the stigma of gay people being potentially tainted. Because despite the tens of thousands of gay men with HIV, there are millions more of us who aren't ashamed to say we're gay, who are honorable enough to want to donate, but can't.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
Monogamous relationship? Monogamy is the custom or condition of having only one mate during a period of time. So, two people in a monogamous relationship that practice [lack of a better word] anal sex certainly provide a shadow of doubt.

I'm not understanding you. Two HIV negative people in a monogomous relationship, regardless of sexual practices, are going to remain HIV negative beyond a shadow of a doubt.

Specializes in Critical Care.

I think the issue is REALISTIC precautions versus knee jerk ones.

Look, I think that ANY promiscuous person should be considered high risk and that is not a statement against ethics but an accurate statement of risk.

But, by the same token, if you have had 1 or less partners for the last 12 months, and are reasonably certain your partner could say the same, the risks of an infection that would escape testing are negligible.

Quantity (not frequency but partners, LOL) and not quality (type) over time should be the issue and the ONLY issue when it comes to sex and donation status.

~faith,

Timothy.

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