Organs from deceased donors with false-positive HIV screening tests: An unexpected benefit of the HOPE act

Christine M. Durand, Samantha E. Halpern, Mary G. Bowring, Gilad A. Bismut, Oyinkansola T. Kusemiju, Brianna Doby, Reinaldo E. Fernandez, Charles S. Kirby, Darin Ostrander, Peter G. Stock, Shikha Mehta, Nicole A. Turgeon, David Wojciechowski, Shirish Huprikar, Sander Florman, Shane Ottmann, Niraj M. Desai, Andrew Cameron, Allan B. Massie, Aaron A.R. TobianAndrew D. Redd, Dorry L. Segev

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Organs from deceased donors with suspected false-positive HIV screening tests were generally discarded due to the chance that the test was truly positive. However, the HIV Organ Policy Equity (HOPE) Act now facilitates use of such organs for transplantation to HIV-infected (HIV+) individuals. In the HOPE in Action trial, donors without a known HIV infection who unexpectedly tested positive for anti-HIV antibody (Ab) or HIV nucleic acid test (NAT) were classified as suspected false-positive donors. Between March 2016 and March 2018, 10 suspected false-positive donors had organs recovered for transplant for 21 HIV + recipients (14 single-kidney, 1 double-kidney, 5 liver, 1 simultaneous liver-kidney). Median donor age was 24 years; cause of death was trauma (n = 5), stroke (n = 4), and anoxia (n = 1); three donors were labeled Public Health Service increased infectious risk. Median kidney donor profile index was 30.5 (IQR 22-58). Eight donors were HIV Ab+/NAT-; two were HIV Ab-/NAT+. All 10 suspected false-positive donors were confirmed to be HIV-noninfected. Given the false-positive rates of approved assays used to screen > 20 000 deceased donors annually, we estimate 50-100 HIV false-positive donors per year. Organ transplantation from suspected HIV false-positive donors is an unexpected benefit of the HOPE Act that provides another novel organ source.

Original languageEnglish (US)
Pages (from-to)2579-2586
Number of pages8
JournalAmerican Journal of Transplantation
Volume18
Issue number10
DOIs
StatePublished - Oct 2018
Externally publishedYes

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Keywords

  • acquired immunodeficiency syndrome (AIDS)
  • clinical research
  • clinical trial
  • donors and donation: donor evaluation
  • infection and infectious agents—viral: human immunodeficiency virus (HIV)
  • infectious disease
  • law
  • legislation
  • organ allocation
  • organ procurement organization
  • organ transplantation in general
  • practice

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Cite this

Durand, C. M., Halpern, S. E., Bowring, M. G., Bismut, G. A., Kusemiju, O. T., Doby, B., Fernandez, R. E., Kirby, C. S., Ostrander, D., Stock, P. G., Mehta, S., Turgeon, N. A., Wojciechowski, D., Huprikar, S., Florman, S., Ottmann, S., Desai, N. M., Cameron, A., Massie, A. B., ... Segev, D. L. (2018). Organs from deceased donors with false-positive HIV screening tests: An unexpected benefit of the HOPE act. American Journal of Transplantation, 18(10), 2579-2586. https://doi.org/10.1111/ajt.14993