Passage of the HOPE Act in 2013 led to important workflow changes within a large US organ procurement organization (OPO). The initial triage process for all referrals to the OPO was altered to accommodate the potential suitability of HIV+ patients. After an initial educational process for the intake coordinators, the level of preliminarily triaged patients stabilized. Areflexic or brain dead patients and those < 60 considered potentially suitable donation after circulatory death (DCD) protocol candidates without apparent contraindications were evaluated in person.

Training of the OPO staff performing initial triage and evaluation of those patients referred from 98 hospitals within our donor service area. required a paradigm shift. Initial interpretation of AIDS by our staff as a contraindication was successfully redirected into effective queries and requests for contact information about the referred patients' HIV providers.

Consistent with the evaluation process for HIV negative referrals, the proportion of patients referred with an HIV positive history led to onsite evaluation was only 39/81 (48%) patients. Most of those patients (25/39, 64%) were not brain dead and did not meet criteria for Donation after Circulatory Death donation protocols (DCD). Medically suitable donor families were approached for authorization for organ donation in a small number of cases. Of those, the majority declined. Nonetheless, 2 patients became organ donors with the transplantation of 4 organs.

HIV positive donors do represent an important new source of deceased donor organs. Facilitation of organ donation from this relatively small proportion of donors who are suitable requires the significant investment of resources to fulfill their evaluation. As always, those organs that are transplanted and the lives that are saved, justify this intensive focus.

CITATION INFORMATION: Friedman A., Huprikar S., Delli Carpini K. You've Gotta Have HOPE: Seeking HIV Donors in a Large US OPO Am J Transplant. 2017;17 (suppl 3).

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