Assessing Solid Organ Donors and Monitoring Transplant Recipients forHuman Immunodeficiency Virus Hepatitis B Virus and Hepatitis C Virus Infection— U.S. Public Health Service Guideline 2020

摘要

The recommendations in this report supersede the U.S Public Health Service (PHS)guideline recommendations for reducing transmission of human immunodeficiencyvirus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) through organtransplantation ( ), hereafter referred to as the 2013 PHSguideline. PHS evaluated and revised the 2013 PHS guideline because of severaladvances in solid organ transplantation, including universal implementation ofnucleic acid testing of solid organ donors for HIV, HBV, and HCV; improvedunderstanding of risk factors for undetected organ donor infection with theseviruses; and the availability of highly effective treatments for infection withthese viruses. PHS solicited feedback from its relevant agencies, subject-matterexperts, additional stakeholders, and the public to develop revised guidelinerecommendations for identification of risk factors for these infections amongsolid organ donors, implementation of laboratory screening of solid organdonors, and monitoring of solid organ transplant recipients. Recommendationsthat have changed since the 2013 PHS guideline include updated criteria foridentifying donors at risk for undetected donor HIV, HBV, or HCV infection; theremoval of any specific term to characterize donors with HIV, HBV, or HCVinfection risk factors; universal organ donor HIV, HBV, and HCV nucleic acidtesting; and universal posttransplant monitoring of transplant recipients forHIV, HBV, and HCV infections. The recommendations are to be used by organprocurement organization and transplant programs and are intended to apply onlyto solid organ donors and recipients and not to donors or recipients of othermedical products of human origin (e.g., blood products, tissues, corneas, andbreast milk). The recommendations pertain to transplantation of solid organsprocured from donors without laboratory evidence of HIV, HBV, or HCV infection.Additional considerations when transplanting solid organs procured from donorswith laboratory evidence of HCV infection are included but are not required tobe incorporated into Organ Procurement and Transplantation Network policy.Transplant centers that transplant organs from HCV-positive donors shoulddevelop protocols for obtaining informed consent, testing and treatingrecipients for HCV, ensuring reimbursement, and reporting new infections topublic health authorities.