The imprisonment of the medics, who insist they are innocent, has caused an international outcry and is seen as one of the last obstacles to attempts by Libya, once an international pariah, to repair ties with the West.
The six were convicted of infecting 438 children with HIV-tainted blood at a hospital in the city of Benghazi. They were first sentenced to death in 2004.
Bulgaria refuses to pay compensation, but has already set up a special fund under the aegis of the EU to help the children and their families.
MORE: A timeline of the case
In prison since 1999, the medics have always protested their innocence and say they had been tortured to make confessions.
Foreign health experts have said poor sanitary condition in the Benghazi hospital were the probable cause for the infections.
Deal Still Possible?
The confirmation of the medics' death sentences today came just one day after hopes were raised that a deal was in the making that would allow them to serve prison terms in Bulgaria, or even be pardoned. The Palestinian doctor would also be eligible for such a deal as he was recently granted a Bulgarian passport.
Despite today's verdict, expectations are that a settlement will be worked out.
Bulgarian journalist Momchil Indzhov, who has been closely following the trial, says any agreement hinges on money.
"Minutes after the news of the confirmation of the death sentences came, the association of relatives of the infected children denied that there had been any deal," Indzhov says. "The European Commission also said they had no information [about a deal]. Nothing [about the reported deal] has officially been confirmed, but unofficially, off the record, it is well known that it is all about money. The Libyans want money."
The 1988 bombing in Lockerbie, Scotland (epa)
Libya has accepted responsibility for the plane bombing and agreed to pay $2.7 billion to the families of the 270 victims.
Bulgaria refuses to pay compensation, but has already set up a special fund under the aegis of the EU to help the children and their families.
Indzhov says Bulgarians hope the High Judicial Council, to which the case will now be referred, will make what would clearly be a political decision. The government-controlled Council has the power to either commute the sentences or even pardon the medics.
"The [confirmation of the death] sentences was expected. We all expected that to happen. Now there is only one hope, that there is going to be a hearing at Libya's Supreme Judicial Council which -- after all other legal procedures have been exhausted -- is the only body that could reject [the death sentences]," he says.
Condemnation, But Hope, Too
After the death sentences were confirmed today, Bulgarian President Georgi Parvanov said Bulgaria insisted on a "swift solution by the High Judicial Council to finally complete the case."
EU leaders also said they were still hopeful a solution could be found to free the medics.
Prime Minister Jose Socrates of Portugal, the current EU president, said his country would do all it can to find a solution.
The United States, along with the EU, has also been pressing Libya to resolve the case. In a letter delivered earlier this week, U.S. President George W. Bush urged President Qaddafi to help in the dispute over the fate of the medics.
The president of the Parliamentary Assembly of the Council of Europe, Rene van der Linden, said he was outraged by the verdict of the Supreme Court and he called on the international community to join forces to erase what he described as a "terrible travesty of justice."
