Abstract
A wide gap between the increasing demand for organs and the limited supply leads to immeasurable loss of life each year. The organ shortage could be attenuated by donors with human immunodeficiency virus (HIV) or hepatitis C virus (HCV). The transplantation of organs from HIV+ deceased donors into HIV+ individuals (HIV D+ /R+) was initiated in South Africa in 2010; however, this practice was forbidden in the USA until the HIV Organ Policy Equity (HOPE) Act in 2013. HIV D+/R+ transplantation is now practiced in the USA as part of ongoing research studies, helping to reduce waiting times for all patients on the waitlist. The introduction of direct acting antivirals for HCV has revolutionized the utilization of donors with HCV for HCV-uninfected (HCV−) recipients. This is particularly relevant as the HCV donor pool has increased substantially in the context of the rise in deaths related to drug overdose from injection drug use. This article serves to review the current literature on using organs from donors with HIV or HCV.
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Abbreviations
- HIV:
-
Human immunodeficiency virus
- HCV:
-
Hepatitis C virus
- HOPE:
-
HIV Organ Policy Equity Act
- US:
-
United States
- DAA:
-
Direct acting antiviral
- ART:
-
Antiretroviral therapy
- OI:
-
Opportunistic infection
- OPO:
-
Organ procurement organization
- FP:
-
False positive
- Ab:
-
Antibody
- Ag:
-
Antigen
- CIT:
-
Cold ischemia time
- KDPI:
-
Kidney donor profile index
- ATG:
-
Antithymocyte globulin
- CMV:
-
Cytomegalovirus
- DGF:
-
Delayed graft function
- IRD:
-
Infectious risk donor
- SVR:
-
Sustained virologic response
- AASLD:
-
American Association for the Study of Liver Diseases
- IRB:
-
Institutional review board
- IDSA:
-
Infectious Diseases Society of America
- CKD:
-
Chronic kidney disease
- SRTR:
-
Scientific Registry of Transplant Recipients
- KT:
-
Kidney transplantation
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Acknowledgements
This work was supported by grant number F32DK124941 (Boyarsky) from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), fellowship number 90088546 (Strauss) from Pearl M. Stetler Fellowship and K24AI144954 (Segev) from National Institute of Allergy and Infectious Diseases (NIAID). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the US Government.
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Boyarsky, B.J., Strauss, A.T. & Segev, D.L. Transplanting Organs from Donors with HIV or Hepatitis C: The Viral Frontier. World J Surg 45, 3503–3510 (2021). https://doi.org/10.1007/s00268-020-05924-1
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DOI: https://doi.org/10.1007/s00268-020-05924-1