*Purpose: HIV+ deceased donors (D+) represent a unique resource for HIV+ recipients but HIV D+ may have medical contraindications to donation or lower authorization rates. Our study aimed to characterize barriers to organ donation among HIV D+ in partnership with Organ Procurement Organizations (OPOs).

*Methods: The study population consisted of HIV D+ who did not have organs used for transplant, including: 1) donors deemed ineligible for organ recovery (deferrals), 2) ineligible donors who donated research blood (research-only), 3) donors with cardiac death who had delayed death in the operating room precluding recovery (DCD authorized-not-recovered), and 4) donors with organs recovered not transplanted (discard). Donor characteristics and reasons for ineligibility were collected either prospectively (coordinators completed electronic survey link) or retrospectively from historical OPO referral reports.

*Results: Between 10/2016 and 10/2018, 34/58 OPOs provided data on 512 HIV D+ who did not have organs used for transplant: 439 (85.7%) deferrals, 68 (13.3%) research-only, 2 (0.4%) DCD authorized-not-recovered, 3 (0.6%) discards. Prospective referrals accounted for 217 cases (42%). Among all D+ referrals, 46.9% were male and 45.3% were African Americans (Table 1). The most common cause of death was anoxia (35.9%) among prospectively reported cases (Table 1). The majority of HIV D+ referrals were in regions 1, 2 and 3 with 135 (26.4%), 106 (20.7%) and 119 (23.2%) referrals respectively (Table 1). Among all D+ referrals, reasons for not progressing to organ recovery included high neurological function (22.5%), acute or chronic organ failure (11.3%) and active AIDS-defining illness (10.4%) (Table 2). Sixteen (2.6%) cases were closed due to no interest from transplant centers or no candidates on the match run (Table 2). 44 (7%) cases were closed due to no authorization (Table 2).

*Conclusions: HIV-specific contraindications to donation were relatively rare among a large sample of HIV D+ referrals in the United States. Contraindications such as high neurological function, AIDS defining illnesses and acute/chronic organ failure are significant reasons for organ donor ineligibility.

« Back to 2019 American Transplant Congress