Testing of Transplant Candidates Aged <12 Years for Infection with HIV, Hepatitis B Virus, and Hepatitis C Virus

Publication Date: July 1, 2022
Last Updated: July 19, 2022

Updated Recommendation

Based on a review of the available data, public comment, discussions with stakeholders from the transplant community, and input from the federal advisory committee, the 2020 PHS guideline (4) has been amended to recommend that candidates who are aged <12 years at the time of transplantation and who have received postnatal infectious disease testing are exempt from pretransplant HIV, HBV, and HCV testing during hospital admission for transplantation.
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Recommendation Grading

Overview

Title

Testing of Transplant Candidates Aged <12 Years for Infection with HIV, Hepatitis B Virus, and Hepatitis C Virus

Authoring Organization

Publication Month/Year

July 1, 2022

Last Updated Month/Year

August 10, 2023

Document Type

Guideline

Country of Publication

US

Document Objectives

The U.S. Public Health Service (PHS) has periodically published recommendations about reducing the risk for transmission of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) through solid organ transplantation (1-4). Updated guidance published in 2020 included the recommendation that all transplant candidates receive HIV, HBV, and HCV testing during hospital admission for transplant surgery to more accurately assess their pretransplant infection status and to better identify donor transmitted infection (4). In 2021, CDC was notified that this recommendation might be unnecessary for pediatric organ transplant candidates because of the low likelihood of infection after the perinatal period and out of concern that the volume of blood drawn for testing could negatively affect critically ill children.* CDC and other partners reviewed surveillance data from CDC on estimates of HIV, HBV, and HCV infection rates in the United States and data from the Organ Procurement & Transplantation Network (OPTN)† on age and weight distributions among U.S. transplant recipients. Feedback from the transplant community was also solicited to understand the impact of changes to the existing policy on organ transplantation. The 2020 PHS guideline was accordingly updated to specify that solid organ transplant candidates aged <12 years at the time of transplantation who have received postnatal infectious disease testing are exempt from the recommendation for HIV, HBV, and HCV testing during hospital admission for transplantation.

Inclusion Criteria

Male, Female, Adolescent, Child, Infant

Health Care Settings

Ambulatory, Hospital, Laboratory services, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Management

Diseases/Conditions (MeSH)

D014180 - Transplantation

Keywords

transplant, solid organ transplant, transplantation, HBV, HIV, HCV

Source Citation

Free RJ, Levi ME, Bowman JS, Bixler D, Brooks JT, Buchacz K, Moorman A, Berger J, Basavaraju SV. Updated U.S. Public Health Service Guideline for Testing of Transplant Candidates Aged <12 Years for Infection with HIV, Hepatitis B Virus, and Hepatitis C Virus - United States, 2022. MMWR Morb Mortal Wkly Rep. 2022 Jul 1;71(26):844-846. doi: 10.15585/mmwr.mm7126a2. PMID: 35771714.