Knowledge, attitudes, and planned practice of HIV-positive to HIV-positive transplantation in US transplant centers

Sarah E. Van Pilsum Rasmussen, Mary Grace Bowring, Ashton A. Shaffer, Macey L. Henderson, Allan Massie, Aaron A.R. Tobian, Dorry L. Segev, Christine M. Durand

Research output: Contribution to journalArticlepeer-review

Abstract

Background: HIV+ donor organs can now be transplanted into HIV+ recipients (HIV D+/R+) following the HIV Organ Policy Equity (HOPE) Act. Implementation of the HOPE Act requires transplant center awareness and support of HIV D+/R+ transplants. Methods: To assess center-level barriers to implementation, we surveyed 209 transplant centers on knowledge, attitudes, and planned HIV D+/R+ protocols. Results: Responding centers (n = 114; 56%) represented all UNOS regions. Fifty centers (93 organ programs) planned HIV D+/R+ protocols (kidney n = 48, liver n = 34, pancreas n = 8, heart n = 2, lung = 1), primarily in the eastern United States (28/50). Most (91.2%) were aware that HIV D+/R+ transplantation is legal; 21.4% were unaware of research restrictions. Respondents generally agreed with HOPE research criteria except the required experience with ≥5 HIV+ transplants by organ type. Centers planning HIV D+/R+ protocols had higher transplant volume, HIV+ recipient volume, increased infectious risk donor utilization, and local HIV prevalence (P < 0.01). Centers not planning HIV D+/R+ protocols were more likely to believe their HIV+ candidates would not accept HIV+ donor organs (P < 0.001). Most centers (83.2%) supported HIV+ living donation. Conclusions: Although many programs plan HIV D+/R+ transplantation, center-level barriers remain including geographic clustering of kidney/liver programs and concerns about HIV+ candidate willingness to accept HIV+ donor organs.

Original languageEnglish (US)
Article numbere13365
JournalClinical Transplantation
Volume32
Issue number10
DOIs
StatePublished - Oct 2018

Keywords

  • HIV
  • HIV-infected donors
  • HOPE Act

ASJC Scopus subject areas

  • Transplantation

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