HBV-positive and HIV-positive organs in transplantation: A clinical guide for the hepatologist

Organ transplantation is a life-saving treatment for patients with end-stage organ disease, a severe condition associated with a high risk of waitlist mortality. It is primarily limited by a shortage of available organs. Maximising available donors can increase access to transplantation. Transplantation from donors positive for HBV and HIV has increased in many countries. However, antiviral therapies need to be readily available for recipients after transplantation to prevent possible reactivation of the virus following the administration of immunosuppressive therapies. Furthermore, the intentional transmission of a virus has practical, ethical, and clinical implications. In this review, we summarise the current research, focusing on grafts from donors positive for the HBV surface antigen, antibodies against the HBV core antigen, and HIV, to help hepatologists and physicians interested in transplantation to select the best antiviral and/or prophylactic regimens for after transplantation. (C) 2022 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Automated summary

Organ transplantation is a life-saving treatment for patients with end-stage organ disease, but it is limited by a shortage of available organs. In recent years, there have been explorations and attempts to transplant organs from HBV and HIV positive donors in some countries. However, post-transplant antiviral therapies are necessary to prevent virus reactivation, and intentional virus transmission has practical, ethical, and clinical implications.