Can my new liver give me any illnesses? Is it tested for HIV before I get it?

The organ bank tests donor organs extensively before their transplantation. Tests for infection with human immunodeficiency virus (HIV), hepatitis B virus, and hepatitis C virus are performed, and the information is given to the transplant team. Depending on the recipient’s disease and severity of illness, the transplant team has the option of using organs with known infections. Many research studies have shown that placing a donor liver with hepatitis C into a recipient with hepatitis C is safe and does not confer any excess risk of liver failure or severity of recurrent hepatitis C. Similarly, patients with hepatitis B can be transplanted with organs from donors with hepatitis B. HIV-positive organs are not used, however.

Livers are tested not only for viruses but also other infections and conditions that might potentially be passed on to the recipient. For example, a donor with a severe blood infection with the Staphylococcus bacteria may not be considered a safe donor because the bacterial infection would likely be transmitted to the recipient. Even if the recipient is currently taking preventive antibiotics, he or she will soon be immunosuppressed; as a consequence, the risk of overwhelming infection immediately after transplantation is very high. The liver and other abdominal organs are also inspected for the presence of non–liver-related cancer.

Organ banks are also adept at acquiring historical information about the donor. Important factors in determining the donor’s eligibility include the donor’s history of drug use, sexual contact, home situation, nutrition, and prior cancers such as melanoma, basal cell skin cancer, and breast cancer. These considerations are risk factors for the potential presence of infectious diseases and communicable malignancies. This information, when provided to the recipient’s transplant team, can be used in making the decision whether to accept that particular organ for the recipient.