Public policy

Statement on Transplantation of Organs from HIV-infected Deceased Donors

With modern antiretroviral therapy, solid organ transplantation has become a safe, effective, and cost-saving modality for treating HIV-infected patients who develop end-stage organ failure [1, 2]. HIV-infected deceased donors represent a potentially novel source of organs for HIV-infected transplant candidates that could decrease waitlist deaths and even shorten the national waitlist in general; early experiences with this practice using a select group of South African donors and recipients are encouraging [3]. Approximately 500 HIV-infected, but otherwise healthy, deceased donors are discarded every year because use of organs from HIV-infected donors has, until recently, been prohibited by the National Organ Transplant Act [4]. With the passage of the HIV Organ Policy Equity Act (HOPE Act) in November 2013, transplant centers may transplant HIV infected donors into HIV-infected recipients under specific research studies.

The American Society of Transplantation supports the implementation of the HOPE Act, including the conduct of research relating to organ transplants from donors who are infected with the human immunodeficiency virus (HIV). The findings of this research can then inform the Secretary of Health and Human Services to establish standards for acquiring and procuring donated organs that are infected with HIV, provided that any such standards ensure that an organ infected with HIV may be transplanted only into individuals who are infected with HIV before receiving such organ.

1. Stock PG, Barin B, Murphy B, Hanto D, Diego JM, Light J, Davis C, Blumberg E, Simon D, Subramanian A, Millis JM, Lyon GM, Brayman K, Slakey D, Shapiro R, Melancon J, Jacobson JM, Stosor V, Olson JL, Stablein DM, Roland ME. Outcomes of kidney transplantation in HIV-infected recipients. New England Journal of Medicine. 2010 Nov 18;363(21):2004-14.

2. Terrault NA, Roland ME, Schiano T, Dove L, Wong MT, Poordad F, Ragni MV, Barin B, Simon D, Olthoff KM, Johnson L, Stosor V, Jayaweera D, Fung J, Sherman KE, Subramanian A, Millis JM, Slakey D, Berg CL, Carlson L, Ferrell L, Stablein DM, Odim J, Fox L, Stock PG; Solid Organ Transplantation in HIV: Multi-Site Study Investigators.Liver Transpl. 2012 Jun;18(6):716-26.

3. HIV-positive-to-HIV-positive kidney transplantation. Muller E, Barday Z, Kahn D. N Engl J Med. 2015 May 21;372(21):2070-1

4. Boyarsky BJ, Hall EC, Singer AL, Montgomery RA, Gebo KA, Segev DL. Estimating the potential pool of HIVinfected deceased organ donors in the United States. American Journal of Transplantation. 2011 Jun;11(6):1209-17.

Approved by the AST Board of Directors on July 22, 2011
Revised and approved by the AST Board of Directors on August 12, 2015

Contact:
Shandie Covington, Executive Director, scovington@myast.org; 856-316-0924
Bill Applegate, Director of Government Relations, bill.applegate@bryancave.com; 202-258-4989