title: An Assessment of HIV-Infected Patients Dying in Care for Deceased Organ Donation in a United States Urban Center.
abstract: Organ transplantation is an acceptable option for human immunodeficiency virus (HIV)-infected patients with end-stage kidney or liver disease. With worse outcomes on the waitlist, HIV-infected patients may actually be disproportionately affected by the organ shortage in the United States. One potential solution is the use of HIV-infected deceased donors (HIVDD), recently legalized by the HIV Organ Policy Equity (HOPE) Act. This is the first analysis of patient-specific data from potential HIVDD, retrospectively examining charts of HIV-infected patients dying in care at six HIV clinics in Philadelphia, Pennsylvania from January 1, 2009 to June 30, 2014. Our data suggest that there are four to five potential HIVDD dying in Philadelphia annually who might yield two to three kidneys and three to five livers for transplant. Extrapolated nationally, this would approximate 356 potential HIVDD yielding 192 kidneys and 247 livers annually. However, several donor risk indices raise concerns about the quality of kidneys that could be recovered from HIVDD as a result of older donor age and comorbidities. On the other hand, livers from these potential HIVDD are of similar quality to HIV-negative donors dying locally, although there is a high prevalence of positive hepatitis C antibody.
authors.affiliation: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: A
authors.initials: A
authors.lastname: Richterman
authors.affiliation: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: D
authors.initials: D
authors.lastname: Sawinski
authors.affiliation: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: P P
authors.initials: PP
authors.lastname: Reese
authors.affiliation: Department of Medicine, Drexel University, Philadelphia, PA.
authors.forename: D H
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Medicine, Temple University, Philadelphia, PA.
authors.forename: H
authors.initials: H
authors.lastname: Clauss
authors.affiliation: Gift of Life Donor Program, Philadelphia, PA.
authors.forename: R D
authors.initials: RD
authors.lastname: Hasz
authors.affiliation: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: A
authors.initials: A
authors.lastname: Thomasson
authors.affiliation: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: D S
authors.initials: DS
authors.lastname: Goldberg
authors.affiliation: Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: P L
authors.initials: PL
authors.lastname: Abt
authors.affiliation: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: K A
authors.initials: KA
authors.lastname: Forde
authors.affiliation: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: R D
authors.initials: RD
authors.lastname: Bloom
authors.affiliation: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: S L
authors.initials: SL
authors.lastname: Doll
authors.affiliation: Philadelphia Department of Public Health, Philadelphia, PA.
authors.forename: K A
authors.initials: KA
authors.lastname: Brady
authors.affiliation: Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: E A
authors.initials: EA
authors.lastname: Blumberg
mesh_terms: D005260:Female; D015658:HIV Infections / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D009927:Tissue and Organ Procurement; D014481:United States; D014505:Urban Population
keywords: Acquired immunodeficiency syndrome; donors and donation: deceased; donors and donation: donor-derived infections; donors and donation: extended criteria; infection and infectious agents; viral: human immunodeficiency virus