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HIV Update, The OPO’s Perspective

HIV Update, The OPO’s Perspective. Recipient = HIV +. HIV infection limits life expectancy. True until 1995. HIV infection limits life expectancy. Recipient = HIV + Donor = HIV -. HIV infection + transplantation is too dangerous. Recipient = Virus + Donor = Virus – or Virus +.

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HIV Update, The OPO’s Perspective

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  1. HIV Update, The OPO’s Perspective

  2. Recipient = HIV + HIV infection limits life expectancy True until 1995

  3. HIV infection limits life expectancy

  4. Recipient = HIV + Donor = HIV - HIV infection + transplantation is too dangerous

  5. Recipient = Virus + Donor = Virus – or Virus +

  6. Donor = HIV + HIV infection + organ donation is illegal True until 11/21/2013

  7. The 2013 HOPE Act

  8. Hepatitis B co-infection – 8 • Hepatitis C co-infection – 18 • Cancer – 19 • Lymphoma – 7 • Prostate – 2 • Laryngeal – 2 • Lung – 2 • Leukemia – 1 • Breast – 1 • Kaposi – 1 • Ovarian – 1 • Germ Cell – 1 • Other - 1 2018 – 148 HIV referrals

  9. HIV antibody +, NAT -: Liver, Kidney, Kidney • HIV antibody +, NAT +: Kidney, Kidney • HIV antibody +, Nat -: Kidneys discarded (25% glomerulosclerosis) • Liver suitable – no interest 2018 – 3 Donors

  10. HIV Organ Donation • Education for all stakeholders is ongoing • Potential in LiveOnNY donor service area still unknown • More work for evaluation and donation fulfillment than general donation • False positive HIV donation significant • Expansion of organ donor pool

  11. Referral of all patients meeting triggers • Allow OPO to make selection • OPO has broad access to expert resources (e.g., Transplant Infectious Disease Experts) Generalization

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