HBV-positive and HIV-positive organs in transplantation: a clinical guide for the hepatologist

: Organ transplantation is a life-saving treatment for patients with end-stage organ disease, a severe condition associated with a high risk of waitlist mortality. It is primarily limited by a shortage of available organs. Maximizing available donors can increase access to transplantation. Transplantation from donors positive for hepatitis B and HIV has increased in many countries. However, antiviral therapies need to be readily available after the transplantation for the recipients to prevent possible reactivation of the virus following the administration of immunosuppressive therapies. Furthermore, the intentional transmission of a virus has practical, ethical, and health implications. In this review, we summarized the current research, focusing on grafts from donors positive for antibodies against the HBV core antigen (anti-HBc), Hepatitis B surface antigen (HBsAg), and HIV, to help hepatologists and physicians interested in transplantation in selecting the best antiviral and/or prophylactic regimen to be administered after transplantation.