HIV-infected donors present novel source of organs for HIV-infected transplant candidates

By Dorry Segev, MD, PhD

A new study published in the American Journal of Transplantation reveals that 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.

For patients with HIV, there is an increased chance of dying while awaiting transplantation, as the HIV itself causes the risk of dying on the waiting list to be higher. The option of deceased donors who were also infected with HIV could shorten this wait time. However, this is now illegal due to a 1988 Congressional bill.

Led by Dorry Segev, MD, PhD, of Johns Hopkins Medical Institutions, researchers utilized Nationwide Inpatient Sample (NIS) and HIV Research Network (HIVRN) data to assess HIV-infected deaths compatible with donation.

An average of 534 potential donors per year were estimated among inpatient deaths of HIV-infected patients captured in NIS. An average of 494 potential donors per year with well-controlled HIV and causes of death compatible with organ donation were estimated among HIV-infected patients in care.

The results show that organs from approximately 500 HIV-infected, but otherwise healthy deceased donors per year are discarded due to a federal ban on the transplantation of HIV-infected organs.

“HIV/AIDS is no longer an immediate death sentence and can be managed as a chronic condition, making the ban on transplantation of HIV-infected organs no longer prudent,” Segev notes. “If Congress reversed its ban on allowing people with HIV to be organ donors after their death, between 500 and 1000 HIV-infected patients with kidney or liver failure each year could get transplants faster. This would reduce their risk of death on the waiting list, improve their survival, and even make the list shorter for everyone else who is also waiting for an organ.”

This study is published in the American Journal of Transplantation.

Full citation: Segev et al. Estimating the Potential Pool of HIV-Infected Deceased Organ Donors in the United States. American Journal of Transplantation; June 2011. DOI: 10.1111/j.1600-6143.2011.03506.x

About the Author: Dorry Segev, MD, PhD, is affiliated with Johns Hopkins Medical Institutions.

American Journal of Transplantation (AJT) is the official journal of the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS). This #1 ranked transplantation journal serves as a forum for debate and re-assessment and is a major new platform for promoting understanding, improving results and advancing science in this dynamic field. Published monthly, AJT provides an essential resource for researchers and clinicians around the world. AJT is now also accessible via its free mobile app for smartphones. Find out more at www.amjtrans.com.