People living with HIV have HIV-specific motivations and concerns regarding living donation to other people with HIV under research protocols, demonstrating that these motivations and concerns may impact a patient’s decision to participate in a potentially lifesaving endeavor, according to a study published in AIDS Care.
Study researchers performed semistructured interviews with 20 people with HIV, all of whom reported a willingness to be a living organ donor. The survey questioned participants on their personal motivations, concerns, and perceived benefits of being a living organ donor. Researchers evaluated patterns among participants’ responses as they relate to general living organ donation and HIV-specific organ donation.
Half of survey participants (50%) reported knowing an individual who was receiving dialysis, 45% of respondents told interviewers they knew someone who was on the organ transplant waitlist, and 30% of participants personally knew a transplant recipient. The general, non-HIV specific motivations were consistent across participants and included the desire to help others or a loved one and religious reasons. In addition, concerns regarding the surgical risk and mortality associated with organ donation were shared among survey respondents.
One HIV-specific motivation included feeling “a sense of solidarity with HIV+ transplant candidates.” Additionally, interviewees were motivated to become living donors for HIV-positive individuals as a means of overcoming the stigma associated with the infection. Feeling a sense of normalcy as well as having a sense of purpose as a living donor were also reported among people with HIV. Concerns among people with HIV included the potential for organ donation to complicate recovery, increase kidney failure risk, and increase the risk of passing on a different virus strain to the patient.
Considering the primary survey participants were black and from urban clinics, the findings from this study may not generalize to the HIV population at large.
Concerns and motivations regarding living donor status in people with HIV should be assessed by physicians and independent living donor advocates, as this “is essential to ensuring that endeavors related to assessing the safety and efficacy of HIV [-positive donor/HIV-positive recipient] transplantation are ethically sound.”
Van Pilsum Rasmussen SE, Henderson ML, Bollinger J, et al. Perceptions, motivations, and concerns about living organ donation among people living with HIV [published online May 3, 2018]. AIDS Care. doi:10.1080/09540121.2018.1469724.