HIV positive attitudes to involvement as donors and recipients in organ transplant programmes

The views of HIV positive people towards organ transplants from HIV positive donors were presented in results from a simple clinic survey, reported by Huda Tada from Coventry and Warwickshire Partnership Trust.

This is important given the scarcity of donor organs irrespective of HIV status.

Efficacy of ART has extended life-expectancy which both increases the number of people for whom transplant may become a life-saving option and makes benefits post-transplant durable. This issue was also highlighted by the change in US federal law in November 2013 to allow HIV positive-to-positive transplantations, including the provision for living donors.

The current study surveyed 206 HIV positive adults attending a single HIV outpatients centre from January to July 2013. Baseline demographics included 59% women, 70% black African, heterosexual 83%, 90% were stable on ART, with mean duration of 6 years since HIV diagnosis and mean of >5 years on ART. Comorbidities were reported by 41% of participants but only 4% reported drug or alcohol use.

The results showed a high acceptance for both donating organs (62% yes, 16% no and 22% unsure) and receiving an organ from an HIV positive donor (55% yes, 18% no, 7% unsure).

Confidentiality, infection and quality of organ were main reasons against. Approximately half the participants agreed they would be happy to both donate and receive an HIV positive organ, if this was appropriate. Black African ethnicity was associated with greater caution for HIV positive organ transplants.

Comment

This cross-sectional survey is important for showing a generally high level of both interest and acceptance of involvement of HIV positive people in organ transplant programmes. It is notable that the survey was performed without educational interventions on the benefits and risks and in a population who were not at critical risk for needing a transplant. Both these factors would be likely to increase positive results.

It would be helpful to have results from a larger study, involving some of the HIV centres with both experience and demand for HIV transplant services.