<scp>HIV</scp>+ deceased donor referrals: A national survey of organ procurement organizations

Cash, Ayla; Luo, Xiaobin; Chow, Eugene M.; Bowring, Mary G.; Shaffer, Ashton A.; Doby, Brianna; Wickliffe, C.; Alexander, Charles E.; McRann, Deborah; Tobian, Aaron A.R.; Segev, Dorry L.; Durand, Christine M.

doi:10.1111/ctr.13171

Cited by 15 publications

(18 citation statements)

References 22 publications

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“…The number of HOPE donors has been lower than the projected potential. 55,56 As with any new practice, we expect that HIV D+/R+ transplantation will be adopted over time with increased engagement at donor hospitals, organ procurement organizations, 57 and transplant centers. 58 Another limitation is ascertainment bias; surveillance biopsies were required in the D+/R+ arm but not all centers routinely performed posttransplant biopsies in D−/R+ recipients.…”

Section: Discussionmentioning

confidence: 99%

A prospective multicenter pilot study of HIV-positive deceased donor to HIV-positive recipient kidney transplantation: HOPE in action

Durand

Zhang

Brown

et al. 2021

American Journal of Transplantation

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Section: Discussionmentioning

confidence: 99%

A prospective multicenter pilot study of HIV-positive deceased donor to HIV-positive recipient kidney transplantation: HOPE in action

Durand

Zhang

Brown

et al. 2021

American Journal of Transplantation

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“…Having an OPO partner willing to help with extended evaluation can be crucial for the HOPE Act to be successful. As highlighted here, additional testing can be necessary, creating additional cost and delay for an OPO 15 yet can also be lifesaving, as in our discovery of donor cryptococcal meningitis. Transplant ID physicians should be willing to ask additional questions or request additional diagnostic procedures of OPO partners if concerns during the donor evaluations arise.…”

Section: Discussionmentioning

confidence: 99%

Donor evaluation in the era of HIV-positive organ transplantation: The importance of the infectious diseases specialist

Hemmersbach‐Miller

Wood²,

Wolfe

2020

American Journal of Transplantation

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A 61‐year‐old female with well‐controlled human immunodeficiency virus (HIV) and end‐stage renal disease was on the kidney transplant waitlist awaiting an organ offer, including from HIV‐positive donors through the HIV Organ Policy Equity (HOPE) Act. We present three different scenarios where HIV‐positive donor offers were evaluated for this one recipient, discuss the donor evaluation process, explain where the infectious diseases provider fits in this scheme, and describe the challenges encountered by organ procurement organizations. This is the first case under the HOPE Act at our center where discovery of an HIV‐specific issue led to a turndown of an organ offer.

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“…Our group recently published a study that included data from 55/58 OPOs on HIV+ donor referrals including “discovered” cases in which an unanticipated HIV serology or NAT result occurred. Using this OPO referral data, there would be an estimated 66 discovered cases of HIV among potential donors each year; many of these discovered cases might represent false-positive tests rather than discovery of acute HIV infections(31). In order for the donation and transplantation community to realize the potential of all donors under the HOPE Act − those with both false-positive and true positive HIV screening tests – wider participation is needed.…”

Section: Discussionmentioning

confidence: 99%

Organs from deceased donors with false-positive HIV screening tests: An unexpected benefit of the HOPE act

Durand

Halpern

Bowring

et al. 2018

American Journal of Transplantation

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Organs from deceased donors with suspected false-positive HIV screening tests were generally discarded due to the chance that the test was truly positive. However, the HIV Organ Policy Equity (HOPE) Act now facilitates use of such organs for transplantation to HIV-infected (HIV+) individuals. In the HOPE in Action trial, donors without a known HIV infection who unexpectedly tested positive for anti-HIV antibody (Ab) or HIV nucleic acid test (NAT) were classified as suspected false-positive donors. Between March 2016 and March 2018, 10 suspected false-positive donors had organs recovered for transplant for 21 HIV + recipients (14 single-kidney, 1 double-kidney, 5 liver, 1 simultaneous liver-kidney). Median donor age was 24 years; cause of death was trauma (n = 5), stroke (n = 4), and anoxia (n = 1); three donors were labeled Public Health Service increased infectious risk. Median kidney donor profile index was 30.5 (IQR 22-58). Eight donors were HIV Ab+/NAT-; two were HIV Ab-/NAT+. All 10 suspected false-positive donors were confirmed to be HIV-noninfected. Given the false-positive rates of approved assays used to screen > 20 000 deceased donors annually, we estimate 50-100 HIV false-positive donors per year. Organ transplantation from suspected HIV false-positive donors is an unexpected benefit of the HOPE Act that provides another novel organ source.

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HIV+ deceased donor referrals: A national survey of organ procurement organizations

Abstract: OPOs reported a high volume of HIV+ referrals annually, of which a subset will be medically eligible for donation. Particularly in areas of high HIV prevalence, OPOs require ongoing support to implement the HOPE Act.

Cited by 15 publications

References 22 publications

A prospective multicenter pilot study of HIV-positive deceased donor to HIV-positive recipient kidney transplantation: HOPE in action

A prospective multicenter pilot study of HIV-positive deceased donor to HIV-positive recipient kidney transplantation: HOPE in action

Donor evaluation in the era of HIV-positive organ transplantation: The importance of the infectious diseases specialist

Organs from deceased donors with false-positive HIV screening tests: An unexpected benefit of the HOPE act

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