Current Situation of Solid Organ Transplantation from HIV-Positive Donors to HIV-Positive Recipients in Europe: the Spanish Perspective

Jose M Miro; Nerea L Amondarain; Lucia Serrano; Spanish LT/KT in HIV-Infected Patients Working Group investigators; European Union of Medical Specialists Section of Infectious Diseases (UEMS-ID) investigators; Sniedze Laivacuma; Indra Zeltiņa

doi:10.1016/j.cmi.2025.08.025

Current Situation of Solid Organ Transplantation from HIV-Positive Donors to HIV-Positive Recipients in Europe: the Spanish Perspective

Jose M Miro (Corresponding Author)
, Nerea L Amondarain
, Lucia Serrano
, Spanish LT/KT in HIV-Infected Patients Working Group investigators
, European Union of Medical Specialists Section of Infectious Diseases (UEMS-ID) investigators
, Sniedze Laivacuma (Under clarification)
, Indra Zeltiņa (Under clarification)

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

OBJECTIVES: There is limited information on the use of organs from HIV-positive donors (HIV D+) for HIV-positive recipients (HIV R+) in Europe. In some countries the use of HIV D+ organs is prohibited by law. This study aimed to assess the attitudes of Spanish kidney and liver transplant (KT/LT) teams towards HIV D+/R+ KT/LT through a nationwide survey, and to evaluate the current situation across Europe regarding legislation and reported cases.

METHODS: In 2018 and 2019, two surveys were conducted across Spain's 24 LT and 39 KT centres, respectively. Specialists in HIV/infectious diseases, nephrology/hepatology, urology/liver surgery and transplant coordination completed a questionnaire, with responses analysed by speciality. We also consulted European representatives on national legal frameworks regarding HIV D+/R+ and conducted a narrative review of published cases (2000-2025).

RESULTS: The Spanish survey was answered by at least one member of all Spanish LT and KT teams (63/63, 100%). Most specialists who responded to the survey (167/252; 66%) supported using organs from HIV D+ virologically suppressed (VS) on ART, high-risk and serodiscordant couples, but not from non-VS HIV D+, for HIV R+. All respondents endorsed implementing a dedicated consent form, and a majority expressed willingness to participate in an HIV D+/R+ trial. No major differences were observed between LT and KT teams. At the European level, the use of organs from HIV D+ was permitted, prohibited or unregulated in 6 (17%), 11 (31.5%) and 18 (51.5%) countries, respectively. Ten HIV D+/R+ transplants (six kidneys and four livers) have been published, with good one-year outcomes.

CONCLUSIONS: The surveyed Spanish specialists would agree on using organs from VS HIV D+ for HIV D+/R+ transplants. This procedure is only legally allowed in very few European countries. These results should promote changes in donor laws across Europe.

Original language	English
Pages (from-to)	137-146
Journal	Clinical Microbiology and Infection
Volume	32
Issue number	1
DOIs	https://doi.org/10.1016/j.cmi.2025.08.025
Publication status	Published - Jan 2026
Externally published	Yes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords*

Europe
HIV-Positive donors
HIV-Positive recipients
Kidney transplantation
Liver transplantation
Spain
Survey

Field of Science*

3.2 Clinical medicine

Publication Type*

1.1. Scientific article indexed in Web of Science and/or Scopus database

Access to Document

10.1016/j.cmi.2025.08.025

Cite this

Miro, J. M., Amondarain, N. L., Serrano, L., Spanish LT/KT in HIV-Infected Patients Working Group investigators, European Union of Medical Specialists Section of Infectious Diseases (UEMS-ID) investigators, Laivacuma, S., & Zeltiņa, I. (2026). Current Situation of Solid Organ Transplantation from HIV-Positive Donors to HIV-Positive Recipients in Europe: the Spanish Perspective. Clinical Microbiology and Infection, 32(1), 137-146. https://doi.org/10.1016/j.cmi.2025.08.025

@article{087380d56127442d9b7261ca32d377cb,

title = "Current Situation of Solid Organ Transplantation from HIV-Positive Donors to HIV-Positive Recipients in Europe: the Spanish Perspective",

abstract = "OBJECTIVES: There is limited information on the use of organs from HIV-positive donors (HIV D+) for HIV-positive recipients (HIV R+) in Europe. In some countries the use of HIV D+ organs is prohibited by law. This study aimed to assess the attitudes of Spanish kidney and liver transplant (KT/LT) teams towards HIV D+/R+ KT/LT through a nationwide survey, and to evaluate the current situation across Europe regarding legislation and reported cases.METHODS: In 2018 and 2019, two surveys were conducted across Spain's 24 LT and 39 KT centres, respectively. Specialists in HIV/infectious diseases, nephrology/hepatology, urology/liver surgery and transplant coordination completed a questionnaire, with responses analysed by speciality. We also consulted European representatives on national legal frameworks regarding HIV D+/R+ and conducted a narrative review of published cases (2000-2025).RESULTS: The Spanish survey was answered by at least one member of all Spanish LT and KT teams (63/63, 100\%). Most specialists who responded to the survey (167/252; 66\%) supported using organs from HIV D+ virologically suppressed (VS) on ART, high-risk and serodiscordant couples, but not from non-VS HIV D+, for HIV R+. All respondents endorsed implementing a dedicated consent form, and a majority expressed willingness to participate in an HIV D+/R+ trial. No major differences were observed between LT and KT teams. At the European level, the use of organs from HIV D+ was permitted, prohibited or unregulated in 6 (17\%), 11 (31.5\%) and 18 (51.5\%) countries, respectively. Ten HIV D+/R+ transplants (six kidneys and four livers) have been published, with good one-year outcomes.CONCLUSIONS: The surveyed Spanish specialists would agree on using organs from VS HIV D+ for HIV D+/R+ transplants. This procedure is only legally allowed in very few European countries. These results should promote changes in donor laws across Europe.",

keywords = "Europe, HIV-Positive donors, HIV-Positive recipients, Kidney transplantation, Liver transplantation, Spain, Survey",

author = "Miro, \{Jose M\} and Amondarain, \{Nerea L\} and Lucia Serrano and Jon Salmanton-Garcia and Christian Manzardo and Daniela Malano-Barletta and David Paredes-Zapata and Antonio Guerra-Maio and Jean-Paul Stahl and Marta Subirana and Pablo Ruiz and Constantino Fondevila and Federic Cof{\'a}n and Angela Gonz{\'a}lez and Mireia Musquera and Beatriz Mahillo and Rosa, \{Gloria de la\} and Rosario Marazuela and Antonio Rimola and Asuncion Moreno and \{Spanish LT/KT in HIV-Infected Patients Working Group investigators\} and \{European Union of Medical Specialists Section of Infectious Diseases (UEMS-ID) investigators\} and Sniedze Laivacuma and Indra Zeltiņa",

note = "Publikācija nav redzama S.Laivacumas un I.Zeltiņas Scopus un Web of Science profilos, lai gan datubāzēs publikācija ir indeksēta. S.Laivacumas un I.Zeltiņas dalība darba grupā ir norādīta pielikumā (Appendix 1) aiz publikācijas pilnā teksta. Copyright {\textcopyright} 2025 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.",

year = "2026",

month = jan,

doi = "10.1016/j.cmi.2025.08.025",

language = "English",

volume = "32",

pages = "137--146",

journal = "Clinical Microbiology and Infection",

issn = "1198-743X",

publisher = "Elsevier B.V.",

number = "1",

}

Miro, JM, Amondarain, NL, Serrano, L, Spanish LT/KT in HIV-Infected Patients Working Group investigators, European Union of Medical Specialists Section of Infectious Diseases (UEMS-ID) investigators, Laivacuma, S & Zeltiņa, I 2026, 'Current Situation of Solid Organ Transplantation from HIV-Positive Donors to HIV-Positive Recipients in Europe: the Spanish Perspective', Clinical Microbiology and Infection, vol. 32, no. 1, pp. 137-146. https://doi.org/10.1016/j.cmi.2025.08.025

TY - JOUR

T1 - Current Situation of Solid Organ Transplantation from HIV-Positive Donors to HIV-Positive Recipients in Europe

T2 - the Spanish Perspective

AU - Miro, Jose M

AU - Amondarain, Nerea L

AU - Serrano, Lucia

AU - Salmanton-Garcia, Jon

AU - Manzardo, Christian

AU - Malano-Barletta, Daniela

AU - Paredes-Zapata, David

AU - Guerra-Maio, Antonio

AU - Stahl, Jean-Paul

AU - Subirana, Marta

AU - Ruiz, Pablo

AU - Fondevila, Constantino

AU - Cofán, Federic

AU - González, Angela

AU - Musquera, Mireia

AU - Mahillo, Beatriz

AU - Rosa, Gloria de la

AU - Marazuela, Rosario

AU - Rimola, Antonio

AU - Moreno, Asuncion

AU - Spanish LT/KT in HIV-Infected Patients Working Group investigators

AU - European Union of Medical Specialists Section of Infectious Diseases (UEMS-ID) investigators

A2 - Laivacuma, Sniedze

A2 - Zeltiņa, Indra

N1 - Publikācija nav redzama S.Laivacumas un I.Zeltiņas Scopus un Web of Science profilos, lai gan datubāzēs publikācija ir indeksēta. S.Laivacumas un I.Zeltiņas dalība darba grupā ir norādīta pielikumā (Appendix 1) aiz publikācijas pilnā teksta. Copyright © 2025 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

PY - 2026/1

Y1 - 2026/1

N2 - OBJECTIVES: There is limited information on the use of organs from HIV-positive donors (HIV D+) for HIV-positive recipients (HIV R+) in Europe. In some countries the use of HIV D+ organs is prohibited by law. This study aimed to assess the attitudes of Spanish kidney and liver transplant (KT/LT) teams towards HIV D+/R+ KT/LT through a nationwide survey, and to evaluate the current situation across Europe regarding legislation and reported cases.METHODS: In 2018 and 2019, two surveys were conducted across Spain's 24 LT and 39 KT centres, respectively. Specialists in HIV/infectious diseases, nephrology/hepatology, urology/liver surgery and transplant coordination completed a questionnaire, with responses analysed by speciality. We also consulted European representatives on national legal frameworks regarding HIV D+/R+ and conducted a narrative review of published cases (2000-2025).RESULTS: The Spanish survey was answered by at least one member of all Spanish LT and KT teams (63/63, 100%). Most specialists who responded to the survey (167/252; 66%) supported using organs from HIV D+ virologically suppressed (VS) on ART, high-risk and serodiscordant couples, but not from non-VS HIV D+, for HIV R+. All respondents endorsed implementing a dedicated consent form, and a majority expressed willingness to participate in an HIV D+/R+ trial. No major differences were observed between LT and KT teams. At the European level, the use of organs from HIV D+ was permitted, prohibited or unregulated in 6 (17%), 11 (31.5%) and 18 (51.5%) countries, respectively. Ten HIV D+/R+ transplants (six kidneys and four livers) have been published, with good one-year outcomes.CONCLUSIONS: The surveyed Spanish specialists would agree on using organs from VS HIV D+ for HIV D+/R+ transplants. This procedure is only legally allowed in very few European countries. These results should promote changes in donor laws across Europe.

AB - OBJECTIVES: There is limited information on the use of organs from HIV-positive donors (HIV D+) for HIV-positive recipients (HIV R+) in Europe. In some countries the use of HIV D+ organs is prohibited by law. This study aimed to assess the attitudes of Spanish kidney and liver transplant (KT/LT) teams towards HIV D+/R+ KT/LT through a nationwide survey, and to evaluate the current situation across Europe regarding legislation and reported cases.METHODS: In 2018 and 2019, two surveys were conducted across Spain's 24 LT and 39 KT centres, respectively. Specialists in HIV/infectious diseases, nephrology/hepatology, urology/liver surgery and transplant coordination completed a questionnaire, with responses analysed by speciality. We also consulted European representatives on national legal frameworks regarding HIV D+/R+ and conducted a narrative review of published cases (2000-2025).RESULTS: The Spanish survey was answered by at least one member of all Spanish LT and KT teams (63/63, 100%). Most specialists who responded to the survey (167/252; 66%) supported using organs from HIV D+ virologically suppressed (VS) on ART, high-risk and serodiscordant couples, but not from non-VS HIV D+, for HIV R+. All respondents endorsed implementing a dedicated consent form, and a majority expressed willingness to participate in an HIV D+/R+ trial. No major differences were observed between LT and KT teams. At the European level, the use of organs from HIV D+ was permitted, prohibited or unregulated in 6 (17%), 11 (31.5%) and 18 (51.5%) countries, respectively. Ten HIV D+/R+ transplants (six kidneys and four livers) have been published, with good one-year outcomes.CONCLUSIONS: The surveyed Spanish specialists would agree on using organs from VS HIV D+ for HIV D+/R+ transplants. This procedure is only legally allowed in very few European countries. These results should promote changes in donor laws across Europe.

KW - Europe

KW - HIV-Positive donors

KW - HIV-Positive recipients

KW - Kidney transplantation

KW - Liver transplantation

KW - Spain

KW - Survey

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UR - https://www-webofscience-com.db.rsu.lv/wos/alldb/full-record/MEDLINE:40907699

UR - https://www-sciencedirect-com.db.rsu.lv/science/article/abs/pii/S1198743X25004239?via%3Dihub

U2 - 10.1016/j.cmi.2025.08.025

DO - 10.1016/j.cmi.2025.08.025

M3 - Article

C2 - 40907699

SN - 1198-743X

VL - 32

SP - 137

EP - 146

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

IS - 1

ER -

Miro JM, Amondarain NL, Serrano L, Spanish LT/KT in HIV-Infected Patients Working Group investigators, European Union of Medical Specialists Section of Infectious Diseases (UEMS-ID) investigators, Laivacuma S et al. Current Situation of Solid Organ Transplantation from HIV-Positive Donors to HIV-Positive Recipients in Europe: the Spanish Perspective. Clinical Microbiology and Infection. 2026 Jan;32(1):137-146. doi: 10.1016/j.cmi.2025.08.025

Current Situation of Solid Organ Transplantation from HIV-Positive Donors to HIV-Positive Recipients in Europe: the Spanish Perspective

Abstract

UN SDGs

Keywords*

Field of Science*

Publication Type*

Access to Document

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