Willingness to Accept and Beliefs Regarding Organs from HIV-Infected Donors: A Multi-Center Survey of Transplant Candidates Living with HIV

S. Rasmussen¹, S. Seaman¹, M. Bowring¹, D. Brown¹, A. Massie¹, A. Tobian¹, M. Henderson¹, F. Fletcher², B. Smith², A. Chao³, N. Gorupati³, K. Prakash⁴, S. Aslam⁴, D. Lee⁵, S. Trinh⁶, V. Kirchner⁷, T. Pruett⁷, G. Haidar⁸, K. Hughes⁸, M. Malinis⁹, D. Segev¹, J. Sugarman¹, C. Durand¹

¹JHU, Baltimore, MD, ²UAB, Birmingham, AL, ³UCSF, San Francisco, CA, ⁴UCSD, San Diego, CA, ⁵Drexel, Philadelphia, PA, ⁶Ochsner, New Orleans, LA, ⁷UMN, Minneapolis, MN, ⁸UPMC, Pittsburgh, PA, ⁹Yale, New Haven, CT

Meeting: 2020 American Transplant Congress

Abstract number: 169

Keywords: HIV virus

Session Information

Session Name: Donor Derived Infections

Session Type: Oral Abstract Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:45pm

Presentation Time: 4:03pm-4:15pm

Location: Virtual

*Purpose: HIV-infected (HIV+) donor to HIV+ recipient (HIV D+/R+) transplantation might improve access to transplantation for candidates living with HIV. However, it is unclear whether HIV+ candidates will accept the currently unknown risks of HIV D+/R+ transplantation, or whether willingness and beliefs regarding HIV D+/R+ transplantation vary among centers.

*Methods: We surveyed 116 HIV+ transplant candidates at nine centers regarding willingness to accept HIV+ and increased infectious risk donor (IRD) organs as well as beliefs regarding their use in transplantation. All HIV+ candidates at each center were recruited, regardless of enrollment in an HIV Organ Policy Equity Act (HOPE) clinical trial of HIV D+/R+ transplants. We compared participant responses from centers that had performed ≥1 HOPE transplant (HIVD+ or HIV false-positive donor) to those from centers that had performed no HOPE transplants using Chi-squared, Fisher’s exact, and Wilcoxon signed-rank tests.

*Results: Most respondents were willing to accept HIV+ deceased donor (DD) organs (84%) and HIV+ living donor (LD) organs (87%). Respondents from centers without HOPE experience were less willing to accept HIV+ DD organs (71% vs. 89% p=0.04, Table 1). Willingness to accept IRD organs was similar among centers with and without HOPE experience (70% vs. 68%, p=0.6). Most participants from centers with and without HOPE experience had discussed HIV D+/R+ transplantation with the transplant team (82% vs. 76%, p=0.5). However, those from centers with HOPE experience were more likely to be aware of the HOPE Act allowing HIV D+/R+ transplants (84% vs. 62%, p=0.02). Respondents who chose not to enroll in a HOPE clinical trial were less likely to believe that HIV D+/R+ transplantation was safe (45% vs. 77%, p=0.02), less likely to believe that HIV D+ organs would work similarly to HIV non-infected donor organs (55% vs. 77%, p=0.04), and more likely to believe they would receive an infection other than HIV from an HIV D+ organ (64% vs. 13%, p<0.01).

*Conclusions: While support of HIV D+/R+ transplantation is high among transplant candidates living with HIV, potential for growth remains as more centers perform HOPE transplants.

To cite this abstract in AMA style:

Rasmussen S, Seaman S, Bowring M, Brown D, Massie A, Tobian A, Henderson M, Fletcher F, Smith B, Chao A, Gorupati N, Prakash K, Aslam S, Lee D, Trinh S, Kirchner V, Pruett T, Haidar G, Hughes K, Malinis M, Segev D, Sugarman J, Durand C. Willingness to Accept and Beliefs Regarding Organs from HIV-Infected Donors: A Multi-Center Survey of Transplant Candidates Living with HIV [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/willingness-to-accept-and-beliefs-regarding-organs-from-hiv-infected-donors-a-multi-center-survey-of-transplant-candidates-living-with-hiv/. Accessed November 22, 2024.

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