Increased Rate of Deceased Donor Liver Transplantation for Candidates Willing to Receive Organs from Donors With HIV.
Academic Article
Overview
abstract
Historically, liver transplant candidates with HIV have experienced high waitlist mortality. Since the HOPE Act expands access to organs from donors with HIV, we assessed the impact of HOPE on liver transplant rate and wait time for this population. We linked data from a multicenter HOPE in Action study to SRTR (2/21/2019-6/1/2024) and used Poisson regression to compare transplant rates among 99 candidates willing to accept HOPE donors (HOPE candidates) to 13495 candidates with or without HIV not listed as willing to accept HOPE donors (non-HOPE candidates) matched on transplant center. The median time to any deceased donor liver transplant (DDLT) was 2.3 months for HOPE and 1.1 years for non-HOPE candidates. Within two years of listing, 90.9% of HOPE versus 58.5% of non-HOPE candidates received a DDLT (p<0.001). HOPE was associated with an overall 3.11-fold higher DDLT incident rate ratio (IRR) (95% CI 2.48-3.88, p<0.001). Stratified by Model for End-Stage Liver Disease (MELD) score categories 6-14, 15-24, 25-34 and 35-40/Status 1, HOPE candidates had 10.12-fold, 5.31-fold, 1.41-fold and 2.90-fold higher DDLT rates, respectively. Willingness to accept livers from donors with HIV improves access to liver transplantation for candidates with HIV.
