Abstract:
BACKGROUND:In 2013, the public health service (PHS) changed the criteria intended to identify organ donors that put the associated organ recipients at increased risk for acquiring human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). The changing donor demographics, organ utilization, and outcomes associated with this change are not known. METHODS:A review of the Organ Procurement and Transplantation Network database was performed to assess the impact of PHS donor designation on organ utilization and outcomes. RESULTS:After the 2013 modification, over 20% of all deceased organ donors in the United States were identified as PHS increased risk. Compared with the standard risk deceased organ donor, the PHS donor was younger, male, died from anoxia, more likely to be HCV and antibody reacting to hepatitis B core antigen+, and less likely to have diabetes or hypertension. Organs from the 18- to 34-year-old deceased donors with PHS risks (but relatively few medical comorbidities) and tested negative for HCV were less frequently transplanted compared with the standard risk donors (3.9 vs 4.2 organs transplanted per donor). However, the transplant patient and graft survival as well as risk of unexpected transmission of HIV, HBV, and HCV were equivalent, irrespective of PHS donor status. CONCLUSIONS:The rationale of using PHS donor designation that negatively impacts utilization of high-quality organs without the benefit of identifying the subset of organs with demonstrable proclivity to transmit HIV, HBV, or HCV needs to be reexamined.
journal_name
Transplantationjournal_title
Transplantationauthors
Pruett TL,Clark MA,Taranto SEdoi
10.1097/TP.0000000000001716subject
Has Abstractpub_date
2017-07-01 00:00:00pages
1670-1678issue
7eissn
0041-1337issn
1534-6080journal_volume
101pub_type
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