Transplanting Organs from Donors with HIV or Hepatitis C: The Viral Frontier

Area of Science:

• Transplantation immunology
• Infectious diseases
• Public health

Background:

• The critical shortage of donor organs leads to significant mortality.
• Organs from donors with human immunodeficiency virus (HIV) or hepatitis C virus (HCV) represent an underutilized resource.
• Advancements in medical science and policy changes are enabling the use of these organs.

Purpose of the Study:

• To review the current literature on organ transplantation using donors with HIV or HCV.
• To highlight the impact of the HIV Organ Policy Equity (HOPE) Act on HIV-positive donor organ utilization in the USA.
• To discuss the role of direct-acting antivirals in enabling transplantation from HCV-positive donors to HCV-negative recipients.

Main Methods:

• Literature review of studies on organ transplantation from HIV-positive and HCV-positive donors.
• Analysis of policy changes, such as the HOPE Act, influencing organ donation practices.
• Examination of the impact of direct-acting antiviral therapies on transplant outcomes.

Main Results:

• HIV-positive to HIV-positive (HIV D+/R+) transplantation, initiated in 2010, is now part of research studies in the USA, reducing wait times.
• The availability of direct-acting antivirals has made transplantation from HCV-positive donors to HCV-uninfected recipients feasible and increasingly common.
• The rise in drug overdose deaths has increased the pool of potential HCV-positive donors.

Conclusions:

• Utilizing organs from donors with HIV and HCV can significantly alleviate the organ shortage crisis.
• Policy changes and therapeutic advancements are crucial for expanding the donor pool and improving transplant accessibility.
• Further research and implementation of these strategies can save numerous lives.