Utilization of organs following implementation of the 2020 United States Public Health Service guideline recommendations.

The 2013 U.S. Public Health Service (PHS) guideline for screening organ donors for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) designated donors with social and behavioral characteristics associated with HIV, HBV, and HCV for transmission as increased risk donors (IRDs) and was associated with an underutilization of IRD organs. In 2020, the PHS guideline was updated to remove the IRD designation and certain risk factor criteria. We analyzed adult and pediatric organ transplantation from 2019 to 2023 to assess the impact of the 2020 guideline on organ utilization. We used logistic regression to calculate adjusted utilization rates. A sensitivity analysis was used to assess pediatric kidney utilization. No statistically significant differences in organ utilization were observed between donors with risk factors and standard risk donors post-PHS guideline updates, except for one subgroup of pediatric kidney transplants. In contrast to a prior analysis which observed underutilization of some organs subsequent to policy changes to conform to the 2013 PHS guideline recommendations, following adoption of the 2020 recommendations, utilization of organs from donors with social and behavioral risk factors for HIV, HCV, and HBV was comparable to standard risk donors.