Donor Exclusionary Criteria to Prevent Transmission of HIV Infection (High Risk Donor, HRD)

 

Use of exclusionary criteria:

(1) If a person who meets any of the exclusionary criteria listed below, then he or she should be excluded as a donor, regardless of HIV antibody test results

(2) Exception: If the recipient's risk of not receiving the organ is deemed greater than the risk of HIV transmission and disease, then the donor organs can be used if informed consent about the possibility of HIV transmission is obtained from the recipient.

 

Exclusionary Criteria: Behavior and History in Adult Donors:

(1) men who have had sex with another man in the preceding 5 years

(2) people who have injected drugs (intravenous, intramuscular, subcutaneous) for nonmedical purposes in the preceding 5 years

(3) persons with hemophilia or related clotting disorder who have received human-derived clotting factor concentrates

(4) men and women who have engaged in sex in exchange for money or drugs in the preceding 5 years

(5) persons who have had sex in the past 5 years with any person who has had the above 4 risk factors or who is known or suspected of being HIV infected

(6) persons who have been exposed in the preceding 12 months to known or suspected HIV-infected blood through percutaneous inoculation or through contact with an open wound, nonintact skin, or mucous membranes

(7) inmates of correctional systems

 

Exclusionary Criteria: Pediatric Donors:

(1) children meeting any of the criteria listed above for adults

(2) children > 18 months of age born to mothers with HIV infection or mothers who meet the behavioral or laboratory exclusionary criteria for adult donor UNLESS the child meets all of the following:

(2a) they have not been breast fed within the last 12 months

(2b) HIV antibody tests are negative

(2c) physical examination and review of medical records do not indicate evidence of HIV infection

(3) children <= 18 months of age who are born to mothers with or at risk for HIV infection

(4) children <= 18 months of age who have been breast fed by a mother with or at risk for HIV infection within the past 12 months

 

Exclusionary Criteria - Laboratory and Medical:

(1) persons who cannot be tested for HIV infection because of refusal, inadequate specimens or any other reason

(2) persons who have a repeatedly positive screening assay for HIV-1 or HIV-2 antibody regardless of the results of supplemental assays

(3) persons whose history, physical examination, medical records or autopsy reveal other evidence of HIV infection or other high risk behavior, including

(3a) diagnosis of AIDS

(3b) unexplained weight loss

(3c) night sweats

(3d) blue or purple spots on the skin or mucous membranes suggesting Kaposi's sarcoma

(3e) unexplained lymphadenopathy lasting > 1 month

(3f) unexplained temperature > 100.5°F (38.6°C) for > 10 days

(3g) unexplained persistent cough and shortness of breath

(3h) opportunistic infections

(3i) unexplained persistent diarrhea

(3j) male-to-male sexual contact

(3k) sexually transmitted disease

(3l) needle tracks or other signs of parenteral drug abuse

 

Limitations:

• As newer technologies for diagnosing HIV infectivity become available, then some of these criteria could be loosened.