International AIDS Society

Wide Variation in HIV Testing of Organ Donors in New York State

Author: Mark Mascolini

20 September 2012

Analysis of HIV screening at all kidney and liver transplant centers in New York State showed wide variation in screening practices, some of which were not optimal.

Recently a kidney donor transmitted HIV to a transplant recipient in New York State. Because the case pointed to limitations in current HIV screening protocols, researchers surveyed all 18 New York kidney and transplant centers about their screening practices.

Most but not all centers evaluated HIV risk behaviors of living donors, but evaluation practices varied widely, as did the extent of HIV testing and prevention counseling. All centers screened living donors with HIV antibody assays during initial donor evaluation or 1 month or more before surgery. But only 9 of the 18 centers repeated HIV testing within 14 days before surgery for all donors or for donors with HIV risk behaviors.

HIV antibody testing can be negative in a recently infected person. Only 8 centers (44%) used more sensitive HIV RNA testing to screen all donors or donors with recognized HIV risk behaviors. Ten centers (55%) never used HIV RNA testing.

The authors believe their results “suggest the need to standardize evaluation of HIV risk behaviors and prevention counseling in New York State to prevent acquisition of HIV by prospective living organ donors, and to conduct HIV antibody testing and nucleic acid testing as close to the time of donation as possible to prevent HIV transmission to recipients.”

Source: Candice K. Kwan, Teeb Al-Samarrai, Lou C. Smith, Charulata J. Sabharwal, Kim A. Valente, Lucia V. Torian, Lisa M. McMurdo, Colin W. Shepard, John T. Brooks, Matthew J. Kuehnert. HIV screening practices for living organ donors, New York State, 2010: need for standard policies. Clinical Infectious Diseases. 2012; 55: 990-995.

For the study abstract

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