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Understanding HIV HBV HCV risks from increased risk donors

June 2017

Understanding the Risk of transmission of HIV, Hepatitis B, and Hepatitis C from U.S. PHS increased risk donors

Summary and Goals

In July 2013, the U.S. Public Health Service (PHS) published new guidelines for reducing human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) transmission during organ transplantation. 

Since implementation of the new policies, the number of potential deceased donors classified as increased risk has increased to almost one in five donors nationally.  Research studies have demonstrated that organs from donors classified as increased risk are less likely to be used than organs from non-increased risk donors. ,  This finding persists despite the fact that post-transplant graft and patient survival with increased risk organs is equal to or better than that with non-increased risk organs.

Survey data have demonstrated that most non-physician transplant providers would like further education regarding the risk of infection associated with increased risk donors. Survey data also show that patients have limited understanding and many misconceptions regarding the definition and implications of the increased risk designation. Accordingly, the OPTN/UNOS Disease Transmission Advisory Committee (DTAC), the American Society of Transplantation (AST), the American Society of Transplant Surgeons (ASTS), and the North American Transplant Coordinators Organization (NATCO) provide this guidance document to help transplant professionals better understand the low risk of window period infection present in PHS increased risk donors.

This resource tool is intended to give educational support for Organ Procurement Organizations (OPOs) and transplant hospitals and is for voluntary use by members. This resource is not OPTN policy, so it does not carry the monitoring or enforcement implications of policy. It is not an official guideline for clinical practice, nor is it intended to be clinically prescriptive or to define a standard of care.

View guidance document 6/2017 (PDF - 637 K)