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HIV-positive woman battles for liver transplant

Monday, August 06, 2001

By Christopher Snowbeck, Post-Gazette Staff Writer

An HIV-positive woman from Massachusetts who has mounted a high-profile fight to pay for her life-saving liver transplant expects to hear this month whether UPMC Health System doctors will add her name to the list of people waiting here for organs.

Belynda Dunn, 49, of Dorchester, Mass., was examined Tuesday by UPMC doctors. A day after the tests, Dunn passed out in her hotel room because of a buildup of ammonia and was taken to the emergency room at UPMC Presbyterian.

After two days in the intensive care unit, Dunn spoke yesterday from her hospital bed about her struggle to get coverage for the transplant -- a fight that has elicited the support of Boston's mayor and an unusual $100,000 donation from the HMO that refuses to pay for the transplant.

"It burns me up that an insurance company can sit back and decide who can live and who can die," Dunn said.

Dunn is HIV-positive, but the disease is under control. What's killing her is hepatitis C, which she has had for 30 years since receiving a blood transfusion during the birth of her son.

Only a handful of HIV-positive patients have ever received liver transplants, but the number has grown as doctors have watched patients live longer with HIV because of new medicines.

In the past 18 months, the University of California San Francisco has provided six kidney and three liver transplants to HIV-positive patients. The university received a $1 million state grant to provide the transplants and is currently working to win a National Institutes of Health grant that would lead to patients being treated at a group of hospitals around the country.

UPMC has been a leader in doing transplants on HIV-positive patients, providing new livers to eight patients. Two of the recipients have died, but the longest-living of the survivors had the transplant three years ago. UPMC has also agreed to place on the waiting list Larry Kramer, the New York writer and AIDS activist.

An AIDS activist herself, Dunn was told by doctors in February that she needed to come to Pittsburgh for a transplant, but when she sought approval for the trip from her health insurer, Neighborhood Health Plan Inc. rejected her transplant as experimental.

Faced with the prospect of having to raise $25,000 for last week's evaluation and then nearly $300,000 for the transplant itself, Dunn went public with her story last month. Boston Mayor Thomas M. Menino responded by creating a fund that will help Dunn and, eventually, other people with HIV who need transplants.

"The mayor is very committed to helping out Ms. Dunn," said Lisa Pollack, a spokeswoman for Menino. "She's been a very positive force in our community."

The fund has received approximately $250,000 in private donations so far, including $100,000 from the parent company of Neighborhood Health Plan. Health plan representatives could not be reached yesterday for comment, but Dunn says the company was simply trying to "save face."

Dunn said her brother would be evaluated by doctors to see if he can donate part of his liver to her. But at this point, it's unclear who would pay for that operation.

Sick people shouldn't have to jump through these hoops, Dunn said. But she's maintaining hope.

"God's running the show," she said. "He has the power and the strength to heal. He has the power and the strength to change minds."

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