Background In 1984 the National Organ Transplant Act banned the recovery of organs from HIV-positive (HIV+) individuals. In 2013 the HIV Organ Policy Equity (HOPE) Act amended this antiquated federal law, permitting the transplantation of HIV-infected (HIV+) organs from living (LD) or deceased donors (DD) into HIV+ recipients under clinical research protocols. Several US transplant centers initiated HOPE research studies. However, many states had separate laws restricting or criminalizing HIV+ organ donation and transplantation. A planned HIV+ living donor transplant in California raised the profile of this issue and highlighted the importance of understanding the impact of these laws on HOPE studies.

Methods We conducted legal research and analysis of state laws that implicate the donation or transfer of HIV+ organs in all U.S. states, D.C. and territories. Using The Center for HIV Law and Policy's “State and Federal Laws and Prosecutions” (2015) we identified states with legal prohibitions and describe types of legal prohibitions, and potential impacts on Organ Procurement Organizations (OPOs), Transplant Centers, and DD or LD HOPE protocols.

Results We identified 3 types of restrictions in 15 states. Ten states prohibit HIV+ individuals from donating organs; of those, 2 states permit HIV+ organ donation with recipient consent. Four states allow HIV+ organ donation for medical research. One state completely prohibits the transfer or use of organs from HIV+ individuals. Conclusion Fifteen states have laws that to some extent restrict HIV+-to-HIV+ transplants. In seven states, HIV+-DD is permissible; only HIV+-LDs are implicated. In three states and one territory, HIV+ transplants are permissible if they occur under current HOPE research protocols. Only Delaware's state statutory ban potentially implicates HIV+ donors, OPOs and transplant centers. This highlights the need for interdisciplinary action involving both transplant and HIV stakeholders.

CITATION INFORMATION: Rasmussen S, Glazier A, Cash A, Henderson M, Boyarsky B, Miller K, Schoettes S, Segev D, Durand C. State Law Restrictions on HIV Positive-to-Positive Transplantation. Am J Transplant. 2017;17 (suppl 3).

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