Background: Prior to the 2013 HIV Organ Policy Equity (HOPE) Act, which enabled research on the transplantation of solid organs from donors with human immunodeficiency virus (HIV) to candidates living with HIV, it was prohibited for HIV+ individuals to donate organs in the United States. In 2015, alongside the release of HOPE Act research criteria, the Organ Procurement and Transplantation Network (OPTN) made organ allocation policy and system changes to allow HIV+ to HIV+ transplantation.
Methods: The OPTN database was queried for all adult kidney registrations ever waiting from November 23, 2015, to December 31, 2022; the cohort was split into a HOPE cohort (ever willing to accept an HIV+ kidney) and a non-HOPE cohort (all remaining).
On 6/18/2020, the Organ Procurement and Transplantation Network (OPTN) implemented new policy replacing OPTN region with a 500 nautical mile (NM) circle around the donor hospital for the purpose of vascularized composite allograft (VCA) allocation. We used OPTN data to assess deceased donor VCA transplants in the 3 years pre- (6/19/2017-6/17/2020) vs. post-implementation (6/18/2020-6/17/2023).
View Article and Find Full Text PDFOn March 15, 2021, the Organ Procurement and Transplantation Network (OPTN) replaced donation service area (DSA) and OPTN region as units of pancreas (PA) allocation with a 250 nautical mile (NM) circle with proximity points. We analyzed OPTN data for kidney-pancreas (KP) and PA candidates, transplants, and donors in the 2 years pre-policy (March 16, 2019, to March 14, 2021) and post-policy (March 15, 2021, to March 14, 2023). As expected, more transplants occurred at hospitals outside the recovering organ procurement organization's DSA post-policy (KP: 32.
View Article and Find Full Text PDFThis year's chapter on vascularized composite allograft (VCA) encompasses reviews of data collected from 2014 (when VCA was included in the Final Rule) through 2022. The present Annual Data Report shows that the number of VCA recipients in the United States continues to be small and has remained consistent from the prior report. The data continue to be limited by sample size, with trends persistently demonstrating a predominance of White males in the young/middle-aged population as both donors and recipients for nonuterus VCA transplants, and White women younger than 35 years as the predominant recipients of uterus transplant.
View Article and Find Full Text PDFYear 2020 marked the first OPTN/SRTR Annual Data Report that included a chapter on vascularized composite allograft (VCA), which encompassed reviews of data collected between 2014 (when VCA was included in the Final Rule) and 2020. The present Annual Data Report shows that the number of VCA recipients in the United States continues to be small and trended downward in 2021. While data continue to be limited by sample size, trends continue to show a predominance in White, young/middle-aged, male recipients.
View Article and Find Full Text PDFAcute stressor experiences may influence cognition, possibly through actions of cognitive flexibility, which comprises the ability to modify cognitive and behavioral strategies in response to changing environmental demands. In the present investigation, we examined the effects of an acute psychosocial stressor (the Trier Social Stress Test) on a specific form of cognitive flexibility, namely that of set-shifting, which was assessed by the Berg's Card Sorting Task (BCST). Among undergraduate students, the stressor promoted better performance on the BSCT relative to that evident among nonstressed individuals, including a reduction of perseverative (an index of enhanced set-shifting) and non-perseverative errors.
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