Seaman, Shanti M.; Van Pilsum Rasmussen, Sarah E.; Nguyen, Anh Q.; Halpern, Samantha E.; You, Susan; Waldram, Madeleine M.; Anjum, Saad K.; Bowring, Mary Grace; Muzaale, Abimereki D.; Ostrander, Darin B.; Brown, Diane; Massie, Allan B.; Tobian, Aaron A. R.; Henderson, Macey L.; Fletcher, Faith E.; Smith, Burke; Chao, Ada; Gorupati, Nishita; Prakash, Katya; Aslam, Saima; Lee, Dong H.; Kirchner, Varvara; Pruett, Timothy L.; Haidar, Ghady; Hughes, Kailey; Malinis, Maricar; Trinh, Sonya; Segev, Dorry L.; Sugarman, Jeremy; Durand, Christine M.
Abstract
Background: HIV-infected (HIV+) donor to HIV+ recipient (HIV D+/R+) transplantation might improve access to transplantation for people living with HIV. However, it remains unknown whether transplant candidates living with HIV will accept the currently unknown risks of HIV D+/R+ transplantation. Methods: We surveyed transplant candidates living with HIV from 9 US transplant centers regarding willingness to accept HIV+ donor organs. Results: Among 116 participants, the median age was 55 years, 68% were men, and 78% were African American. Most were willing to accept HIV+ living donor organs (87%), HIV+ deceased donor organs (84%), and increased infectious risk donor organs (70%). Some (30%) were concerned about HIV superinfection; even among these respondents, 71% were willing to accept an HIV D+ organ. Respondents from centers that had already performed a transplant under an HIV D+/R+ transplantation research protocol were more willing to accept HIV+ deceased donor organs (89% vs. 71%,P= 0.04). Respondents who chose not to enroll in an HIV D+/R+ transplantation research protocol were less likely to believe that HIV D+/R+ transplantation was safe (45% vs. 77%,P= 0.02), and that HIV D+ organs would work similar to HIV D- organs (55% vs. 77%,P= 0.04), but more likely to believe they would receive an infection other than HIV from an HIV D+ organ (64% vs. 13%,P< 0.01). Conclusions: Willingness to accept HIV D+ organs among transplant candidates living with HIV does not seem to be a major barrier to HIV D+/R+ transplantation and may increase with growing HIV D+/R+ transplantation experience.
