An Assessment of HIV-Infected Patients Dying in Care for Deceased Organ Donation in a United States Urban Center

A. Richterman, D. Sawinski, P. P. Reese, D. H. Lee, H. Clauss, R. D. Hasz, A. Thomasson, D. S. Goldberg, P. L. Abt, K. A. Forde, R. D. Bloom, S. L. Doll, K. A. Brady, E. A. Blumberg

Research output: Contribution to journalReview articlepeer-review

35 Scopus citations

Abstract

Organ transplantation is an acceptable option for human immunodeficiency virus (HIV)-infected patients with end-stage kidney or liver disease. With worse outcomes on the waitlist, HIV-infected patients may actually be disproportionately affected by the organ shortage in the United States. One potential solution is the use of HIV-infected deceased donors (HIVDD), recently legalized by the HIV Organ Policy Equity (HOPE) Act. This is the first analysis of patient-specific data from potential HIVDD, retrospectively examining charts of HIV-infected patients dying in care at six HIV clinics in Philadelphia, Pennsylvania from January 1, 2009 to June 30, 2014. Our data suggest that there are four to five potential HIVDD dying in Philadelphia annually who might yield two to three kidneys and three to five livers for transplant. Extrapolated nationally, this would approximate 356 potential HIVDD yielding 192 kidneys and 247 livers annually. However, several donor risk indices raise concerns about the quality of kidneys that could be recovered from HIVDD as a result of older donor age and comorbidities. On the other hand, livers from these potential HIVDD are of similar quality to HIV-negative donors dying locally, although there is a high prevalence of positive hepatitis C antibody.

Original languageEnglish (US)
Pages (from-to)2105-2116
Number of pages12
JournalAmerican Journal of Transplantation
Volume15
Issue number8
DOIs
StatePublished - Aug 1 2015
Externally publishedYes

Keywords

  • Acquired immunodeficiency syndrome
  • donors and donation: deceased
  • donors and donation: donor-derived infections
  • donors and donation: extended criteria
  • infection and infectious agents
  • viral: human immunodeficiency virus

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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