Expanding deceased donor kidney transplantation: medical risk, infectious risk, hepatitis C virus, and HIV.

Abstract:

PURPOSE OF REVIEW:Due to the organ shortage, which prevents over 90 000 individuals in the United States from receiving life-saving transplants, the transplant community has begun to critically reevaluate whether organ sources that were previously considered too risky provide a survival benefit to waitlist candidates. RECENT FINDINGS:Organs that many providers were previously unwilling to use for transplantation, including kidneys with a high Kidney Donor Profile Index or from increased risk donors who have risk factors for window period hepatitis C virus (HCV) and HIV infection, have been shown to provide a survival benefit to transplant waitlist candidates compared with remaining on dialysis. The development of direct-acting antivirals to cure HCV infection has enabled prospective trials on the transplantation of organs from HCV-infected donors into HCV-negative recipients, with promising preliminary results. Changes in legislation through the HIV Organ Policy Equity Act have legalized transplantations from HIV-positive deceased donors to HIV-positive recipients for the first time in the United States. SUMMARY:Critical reexamination of deceased donor organs that were previously discarded has resulted in greater utilization of these organs, an increased number of deceased donor transplants, and the provision of life-saving treatment to more transplant waitlist candidates.

authors

Ruck JM,Segev DL

doi

10.1097/MNH.0000000000000456

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

445-453

issue

6

eissn

1062-4821

issn

1473-6543

journal_volume

27

pub_type

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