Organ Donors with Human Immunodeficiency Virus and Hepatitis C Virus: Expanding the Donor Pool

Area of Science:

• Transplantation immunology
• Infectious diseases in transplantation
• Organ donor utilization

Background:

• Organs from donors with treatable infections can enhance transplant quality and quantity.
• Pilot studies of HIV-positive donor to HIV-positive recipient kidney and liver transplants show excellent early outcomes.
• Barriers currently limit the number of HIV-positive donor transplants performed annually.

Purpose of the Study:

• To review the current status and potential of using organs from donors with treatable infections for transplantation.
• To highlight the success of Hepatitis C virus (HCV) infected donor organs in uninfected recipients.
• To identify challenges and opportunities in expanding organ donor pools.

Main Methods:

• Review of pilot studies and clinical outcomes for HIV and HCV donor organ transplantation.
• Analysis of factors influencing donor and transplant numbers.
• Evaluation of treatment strategies for recipients of organs from infected donors.

Main Results:

• HIV donor to recipient transplants demonstrate promising early results but face implementation barriers.
• HCV donor organs are increasingly used in HCV-uninfected recipients due to effective direct-acting antiviral therapies.
• HCV donor organ transplantation is associated with good outcomes and reduced waiting times across various organ types.

Conclusions:

• Expanding the use of organs from donors with treatable infections, particularly HCV, is a viable strategy to increase organ availability.
• Overcoming barriers in HIV donor organ transplantation is crucial for realizing its full potential.
• Direct-acting antivirals have revolutionized the use of HCV-infected donor organs, benefiting a wider recipient population.