Organs From High Risk Patients May Be Okay for Donation

Transplants of high risk donor kidneys had no sign of HIV or hepatitis infection years later

(RxWiki News) People at risk for certain infectious diseases are usually disqualified from being blood donors. However, new research suggests that they may still be safe organ donors.

A recent study looked at organ recipients who received organs from donors who were at high-risk for infection with HIV or the hepatitis viruses B and C.

The results of the study showed that the vast majority of these organ recipients were doing well and showed no signs of infection more than two years later.

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Moya Gallagher, RN, from New York-Presbyterian Hospital/Columbia University Medical Center, led this investigation into organ selection guidelines for donors who may have had certain types of infections.

According to the authors of this study, roughly 10 percent of kidneys procured for organ donation met the criteria laid out by the Centers for Disease Control and Prevention (CDC) as “high-risk” for infection and possible transference of the disease to the organ recipient.

High-risk infections included human immunodeficiency virus (HIV), hepatitis C (HCV) and hepatitis B (HBV).

For this study, the researchers looked at 170 organ transplant patients who had been given a kidney from a donor with a high-risk for infection. 

All of the recipient patients were given the standard of care immunosuppressive medications for organ transplant recipients.

Most of the patients had been on an organ wait list for an average of 1.7 years and 27.7 percent of them experienced some level of delayed function with the organ after transplant.

Among the organ donors, 57.1 percent had a history of injected drug use, 25.9 percent had a history of high-risk sexual behavior, 11.8 percent had been in prison or jail, 7.1 percent of the men had a history homosexual intercourse and 4.7 percent had received several blood transfusions.

After 2.4 years from the time of the organ transplant, 86.5 percent of the organ recipients were doing well with no evidence of having picked up the infection present in the organ donor.

The study authors concluded that all 170 of the high-risk organs were relatively safe for the recipients, and that donors with risk factors for HIV, HCV or HBV should be labeled as “identified risk” instead of “high risk.”

“Utilization of these organs represents an opportunity for shortening wait time for patients while providing good outcomes and an extremely low level of risk for transmission of infections,” Gallagher said in a press statement.

Michelle Segovia, Senior Communications Coordinator for the northern region of the Texas Organ Sharing Alliance (TOSA), said "Organ Procurement Organizations (OPO) conduct extensive medical screenings to assess the quality of organs and identify the risk of transmittable diseases such as HIV and Hepatitis B and C. At our organization, HIV would be an automatic rule out for donation but donors with Hepatitis B and C can certainly donate to a patient who already has Hepatitis."

She continued, "There are more than 120,000 people awaiting a life-saving transplant in this country and 19 die each day because of the drastic organ shortage. Transplant centers, OPOs and the CDC recognize that a patient’s risk of dying without a transplant is often much higher than the possible risk of acquiring a disease."

This study was presented at the American Society of Nephrology Kidney Week 2013 in Atlanta, Georgia. This study has not yet been published in a peer-reviewed journal.

Several of the study's co-authors reported potential conflicts of interest with Alexion, Novartis, Pfizer, Genetech, Gambro, Quark, Bristol Myers Squibb, Genzyme, Astelas and Sandoz.

Review Date: 
October 24, 2013