In the first-of-its-kind study since the passage of the HIV Organ Policy Equity Act (the HOPE Act), which lifted the ban on organ donations from one HIV-positive person to another, Penn Medicine researchers report on the quality of these organs and how their use might impact the country’s organ shortage.  The study, published online ahead of print May 14 in the American Journal of Transplantation, revealed that there are nearly 400 HIV-positive potential organ donors who could be sources of donated organs annually for HIV-positive patients waiting for organ donations.

“The findings are significant because there are not enough organ donors in the United States to meet the needs of all of the patients who might benefit from life-saving organ transplants,” said the study’s senior author, Emily Blumberg, MD, a professor in the division of Infectious Diseases at the Perelman School of Medicine at the University of Pennsylvania. “Some of the patients waiting for organs are infected with HIV but never make it to transplant because they either die while waiting or become too sick to be transplanted. HIV patients who undergo transplantation generally do well, so it is important to continue to look for ways to improve access to transplantation for them.”

In addition, she noted, increasing the number of HIV-positive donors could help all patients on the list simply by expanding donor options for the HIV patients already on the list who are waiting for organs. It remains illegal to transplant organs from HIV-positive donors to HIV-negative recipients because of the likely transmission of HIV. 
The Penn researchers and their colleagues arrived at their estimate by reviewing the records of 578 HIV-positive patients who died at six large Philadelphia HIV clinics to determine their potential suitability as deceased donors. 

Their mean age was 53 years, 68 percent were male, and 73 percent were African American. Using standard criteria for donor selection, they estimated that of this original pool there were four to five potential donors annually in the Philadelphia area who might be a source of two to three kidneys and four to five livers. They arrived at their figure of nearly 400 potential organ donors annually in the United States by extrapolating their Philadelphia results. 

“Unfortunately, the standard measurements of organ quality that we used suggest that many of the donor kidneys may be of reduced quality with decreased viability over the long term when compared with ideal donor kidneys,” said the study’s lead author, Aaron Richterman, a fourth-year medical student in the Perelman School of Medicine.

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