Jose M Miro, Nerea L Amondarain, Lucia Serrano, Jon Salmanton-Garcia, Christian Manzardo, Daniela Malano-Barletta, David Paredes-Zapata, Antonio Guerra-Maio, Jean-Paul Stahl, Marta Subirana, Pablo Ruiz, Constantino Fondevila, Federic Cofán, Angela González, Mireia Musquera, Beatriz Mahillo, Gloria de la Rosa, Rosario Marazuela, Antonio Rimola, Asuncion Moreno
{"title":"Current Situation of Solid Organ Transplantation from HIV-Positive Donors to HIV-Positive Recipients in Europe. The Spanish Perspective.","authors":"Jose M Miro, Nerea L Amondarain, Lucia Serrano, Jon Salmanton-Garcia, Christian Manzardo, Daniela Malano-Barletta, David Paredes-Zapata, Antonio Guerra-Maio, Jean-Paul Stahl, Marta Subirana, Pablo Ruiz, Constantino Fondevila, Federic Cofán, Angela González, Mireia Musquera, Beatriz Mahillo, Gloria de la Rosa, Rosario Marazuela, Antonio Rimola, Asuncion Moreno","doi":"10.1016/j.cmi.2025.08.025","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>There is limited information on the use of organs from HIV-positive donors (HIV D+) for HIV-positive recipients (HIV R+) in Europe. In some countries the use of HIV D+ organs is prohibited by law. This study aimed to assess the attitudes of Spanish kidney and liver transplant (KT/LT) teams towards HIV D+/R+ KT/LT through a nationwide survey, and to evaluate the current situation across Europe regarding legislation and reported cases.</p><p><strong>Methods: </strong>In 2018 and 2019, two surveys were conducted across Spain's 24 LT and 39 KT centres, respectively. Specialists in HIV/infectious diseases, nephrology/hepatology, urology/liver surgery and transplant coordination completed a questionnaire, with responses analysed by speciality. We also consulted European representatives on national legal frameworks regarding HIV D+/R+ and conducted a narrative review of published cases (2000-2025).</p><p><strong>Results: </strong>The Spanish survey was answered by at least one member of all Spanish LT and KT teams (63/63, 100%). Most specialists who responded to the survey (167/252; 66%) supported using organs from HIV D+ virologically suppressed (VS) on ART, high-risk and serodiscordant couples, but not from non-VS HIV D+, for HIV R+. All respondents endorsed implementing a dedicated consent form, and a majority expressed willingness to participate in an HIV D+/R+ trial. No major differences were observed between LT and KT teams. At the European level, the use of organs from HIV D+ was permitted, prohibited or unregulated in 6 (17%), 11 (31.5%) and 18 (51.5%) countries, respectively. Ten HIV D+/R+ transplants (six kidneys and four livers) have been published, with good one-year outcomes.</p><p><strong>Conclusions: </strong>The surveyed Spanish specialists would agree on using organs from VS HIV D+ for HIV D+/R+ transplants. This procedure is only legally allowed in very few European countries. These results should promote changes in donor laws across Europe.</p>","PeriodicalId":10444,"journal":{"name":"Clinical Microbiology and Infection","volume":" ","pages":""},"PeriodicalIF":8.5000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Microbiology and Infection","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.cmi.2025.08.025","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: There is limited information on the use of organs from HIV-positive donors (HIV D+) for HIV-positive recipients (HIV R+) in Europe. In some countries the use of HIV D+ organs is prohibited by law. This study aimed to assess the attitudes of Spanish kidney and liver transplant (KT/LT) teams towards HIV D+/R+ KT/LT through a nationwide survey, and to evaluate the current situation across Europe regarding legislation and reported cases.
Methods: In 2018 and 2019, two surveys were conducted across Spain's 24 LT and 39 KT centres, respectively. Specialists in HIV/infectious diseases, nephrology/hepatology, urology/liver surgery and transplant coordination completed a questionnaire, with responses analysed by speciality. We also consulted European representatives on national legal frameworks regarding HIV D+/R+ and conducted a narrative review of published cases (2000-2025).
Results: The Spanish survey was answered by at least one member of all Spanish LT and KT teams (63/63, 100%). Most specialists who responded to the survey (167/252; 66%) supported using organs from HIV D+ virologically suppressed (VS) on ART, high-risk and serodiscordant couples, but not from non-VS HIV D+, for HIV R+. All respondents endorsed implementing a dedicated consent form, and a majority expressed willingness to participate in an HIV D+/R+ trial. No major differences were observed between LT and KT teams. At the European level, the use of organs from HIV D+ was permitted, prohibited or unregulated in 6 (17%), 11 (31.5%) and 18 (51.5%) countries, respectively. Ten HIV D+/R+ transplants (six kidneys and four livers) have been published, with good one-year outcomes.
Conclusions: The surveyed Spanish specialists would agree on using organs from VS HIV D+ for HIV D+/R+ transplants. This procedure is only legally allowed in very few European countries. These results should promote changes in donor laws across Europe.
期刊介绍：
Clinical Microbiology and Infection (CMI) is a monthly journal published by the European Society of Clinical Microbiology and Infectious Diseases. It focuses on peer-reviewed papers covering basic and applied research in microbiology, infectious diseases, virology, parasitology, immunology, and epidemiology as they relate to therapy and diagnostics.
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