Background: The HIV Organ Policy Equity (HOPE) Act, enacted on 11/21/13, allows for research on transplants of kidneys (KI) or livers (LI) from HIV+ donors into HIV+ recipients. On 11/21/15, the OPTN revised policy/programming, and on 11/23/15, the Secretary of HHS published criteria for conducting this research and revised the Final Rule accordingly.

Results: As of 11/18/16 there are 20 programs among 13 approved centers. There have been 41 matches run for 14 potential HIV+ deceased donors from 13 OPO's.Seven deceased donors [KDPI (%) (median: 28, IQR: 25–43)] resulted in 19 transplants (13 KI, 6 LI [including 1 KI/LI multi-organ transplant]) by 4 approved centers; all but 2 were from deceased donors outside the recipient center DSA. As of 11/18/16, 83 waiting list candidates are indicated as willing to accept an HIV+ organ (88% waiting in active status).There have been 6 LI transplants, of which 5 were male; the median age was 51 (IQR: 47 – 55). Two recipients each were White, Black, and Hispanic, and 3 recipients each were blood types A and O. As of 11/18/16, 5 LI candidates are willing to accept an HIV+ LI (all waiting in active status), and all LI candidates/recipients have Cirrhosis.

Conclusion: The HOPE Act has not been widely utilized and many approved centers have not performed transplants. Organs transplanted per donor (OTPD) thus far is 2.7. Given the maximum OTPD for a HOPE donor is 3, there is an inherent disincentive for OPO's to utilize HOPE donors as they are currently assessed by CMS on donor yield. However, as safety data are reviewed and disseminated, it's anticipated that more programs may see the viability of these donors, resulting in an increase in transplants.

CITATION INFORMATION: Wilk A, Taranto S, Urban R, Klassen D. HOPE Act – The First Year. Am J Transplant. 2017;17 (suppl 3).

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