FAQ
General
What is the purpose of this site?
This site provides resources and updates for thoracic transplant centers that are either initiating pilot HOPE studies or are interested in participating in future funded work.
Lung transplant
Has a HOPE (HIV D+/R+) lung transplant been performed to date?
To date, no center worldwide has performed an HIV D+/R+ lung transplant
Is there a national trial of HIV D+/R+ lung transplant?
While individual centers have developed their own protocols and may collaborate in their development, there is currently no national trial.
How have centers developed their independent lung protocols?
Individual transplant centers develop their protocols to be compatible with criteria established by the Department of Health and Human Services.
What role does HOPE Thoracic play in current heart pilot protocols?
HOPE Thoracic aims to reduce the barrier for centers to initiate their protocols by providing guidance and resources. Center are free to
Heart transplant
Has a HOPE (HIV D+/R+) heart transplant been performed to date?
Yes. Several centers in the United States have performed HIV D+/R+ heart transplants, and others are evaluating patients under open research protocols.
What is the current status of funding for a national trial of HIV D+/R+ heart transplant?
At present, there is no funded national trial. However, an application has been submitted to the United States National Institutes of Health for future funding.
How have centers developed their heart protocols?
Individual transplant centers develop their protocols to be compatible with criteria established by the Department of Health and Human Services.
What role does HOPE Thoracic play in current heart pilot protocols?
HOPE Thoracic aims to reduce the barrier for centers to initiate their protocols by providing guidance and resources.
Donor evaluation
How are potential donors evaluated under HOPE protocols?
As with donors without HIV, the evaluation process is initiated by organ procurement organizations (OPOs) and shared via DonorNet. OPOs are encouraged to contact the HOPE-in-Action team, which can help obtain information specific to the donor’s HIV status and prior/current treatment. This information is typically shared via the active HOPE listserv.
Who makes the ultimate decision about accepting a donor for transplant?
As with all solid organ transplants, the decision rests with each individual transplant center and the patient (potential recipient). The HOPE-in-Action team serves as a resource for information and coordination but does not make the final decision.
Are there specific CD4+ lymphocyte count or viral load thresholds that determine donor eligibility?
No. There are no mandated thresholds. Kidney and liver transplant teams in the United States have successfully transplanted organs from donors with low CD4 counts or high viral loads, provided that opportunistic infection and malignancy are excluded through careful vetting.
Recipient evaluation
How are potential recipients evaluated under HOPE protocols?
Pending.