Spain repeals 1987 regulation and opens the door to organ donation from HIV+ individuals.

In an effort to modernize its approach to organ donation and adapt to scientific advancements in HIV treatment, Spain has decided to initiate the process to repeal a 1987 regulation that prohibited the use of organs from HIV-positive donors. This measure, announced by the Ministry of Health on the occasion of World AIDS Day, follows a global trend aimed at addressing organ donation in a more inclusive and less discriminatory manner. Historically, the relationship between HIV and transplantation has been marked by fear and uncertainty. In the 1980s, HIV was seen as a deadly disease, and the fear of virus transmission led to the creation of restrictive criteria that excluded many potential donors. The 1987 regulation, which prohibited the transplantation of organs from HIV+ donors, reflects the panic and ignorance that characterized that era. However, the evolution of knowledge about HIV and antiretroviral treatments has drastically changed the situation. Today, the virus is effectively managed, and the possibility of transplanting organs from HIV+ donors has been demonstrated to be safe in other countries. In this sense, the repeal of the 1987 regulation represents a significant change in Spain's public health policy, aligning it with practices adopted in other nations where positive outcomes have been recorded. Since the introduction of effective antiretroviral treatments in the 1990s, numerous organ transplants have been performed in HIV+ patients in both France and the United States, leading to the normalization of this practice. In Spain, the first kidney transplant to an HIV-positive patient was conducted in 2001, and since then, more than 800 HIV+ patients have received transplants of various organs, although the number remains relatively low compared to the need. One of the barriers that has limited organ donation from HIV+ donors in Spain has been the lack of a legal framework that would allow their inclusion in the transplant process. With the announcement of the repeal, it is expected that the possibility for these donors to contribute their organs will be facilitated, thus helping to save lives and reduce the waiting list for patients in need of a transplant. The National Transplant Organization (ONT) has estimated that, in the last decade, at least 65 donors were discarded due to their HIV positivity. This figure could be even higher, as many potential donors were not even considered due to their HIV status. With the new regulation, it is anticipated that doors will open for a significant number of previously excluded donors, which could lead to an increase in the number of transplants performed. Although it is acknowledged that the number of transplants that could be performed with organs from HIV+ donors will not be massive, every saved life counts. It is estimated that around 50 HIV+ patients enter the waiting list for a transplant each year, many of whom could benefit from this new policy. The ONT has calculated a potential of 15 donors that could translate into approximately 38 transplants per year, although reaching these figures will require coordinated effort. This change in regulation not only has practical implications for the transplant system but also represents an important advancement in the fight against the stigmatization of people living with HIV. By allowing HIV+ donors to contribute to the transplant system, a clear message of inclusion and acceptance is sent, aligning with the philosophy that everyone has the right to donate their organs if they wish to do so. In the coming months, it is expected that the repeal will be formally realized, and a process will begin to integrate this new reality into the national health system. As progress is made in this direction, the hope is that more lives will be saved and that greater awareness and education about HIV and organ donation will be fostered. In summary, Spain is taking a step forward by recognizing that the exclusion of HIV+ donors is outdated and that public health should be based on current scientific evidence. This legal change will not only benefit patients awaiting a transplant but will also help dismantle the myths surrounding HIV, promoting a fairer and more equitable society for all.