HIV Organ Policy Equity (HOPE) Act

Public Law No: 113-51

Organ Donations

Major advances in the treatment of HIV and AIDS mean that HIV-positive individuals are living longer, and like other Americans, they too are developing medical conditions that require organ transplant.  However, the number of individuals in need of organ transplants far exceeds the availability of healthy organs; almost 80,000 patients are actively waiting for life-saving organs and on average 22 people die each day while waiting for a transplant. 

The HOPE Act

Before the Hope Act was passed, federal laws on organ transplants, as well as federal criminal statutes, prohibited organs from deceased, HIV-positive donors to be used for transplant to HIV-positive recipients. The HIV Organ Policy Equity (HOPE) Act, which became law on November 21, 2013, permits donated, HIV-positive organs to be used for transplantation in HIV-positive patients. In addition to amending federal criminal law regarding HIV transmission to clarify that such organ donations are not barred, the HOPE Act directs the Department of Health and Human Services and the Organ Procurement Transplant Network (OPTN) to develop and institute standards for research on HIV-positive organ transplantation. In May 2015, the Department of Health and Human Services issued final regulations on this issue.

Under the new rules, individuals who are HIV-positive and participating in an institutional review board approved clinical research trial have the option of receiving an organ from an HIV-positive individual. Since organ transplants from an HIV-positive donor to an HIV-positive recipient have not been permitted in the United States, HHS deemed it necessary to restrict such transplants to the research setting in order to demonstrate the safety of the procedure. The Secretary of HHS has the latitude to waive this requirement in the future if it is determined that it is ‘no longer warranted’ to ensure safety of patients. Such a revision would have the potential to significantly reduce the time an HIV-positive individual waits for a life-saving transplant. The new regulations went into effect on June 8, 2015, and on March 30, 2016, physicians at Johns Hopkins University School of Medicine in Baltimore, Maryland announced they had successfully completed the nation’s first ever transplant of an HIV-positive organ from a deceased individual to an HIV-positive individual.


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Last Updated: April 7, 2016