Dear OPTN Members,
Patient safety is a foundational pillar of the OPTN. Every policy we establish is intended to support safe, fair organ transplantation while maintaining public trust in the national organ donation, procurement, and transplantation system.
Today, I am writing to provide advance notice of an important policy change that the OPTN Board of Directors recently approved through emergency action that we first shared in a recent implementation notice. This action shortens the required testing windows in living and deceased donors for Human Immunodeficiency Virus (HIV) and West Nile Virus (WNV) nucleic acid testing (NAT) from 28 days and 14 days, respectively, to a uniform requirement that testing be performed within 7 days prior to organ recovery.
This policy will become effective on Aug. 17, 2026. Based on the implementation date of August 17, 2026 for WNV and HIV testing, WNV and HIV testing results must be available from within 7 days for all living donor donations that occur on or after August 24, 2026.
The Board does not invoke its emergency policy authority lightly. In this case, however, the circumstances warranted swift action.
Recent investigations identified donor-derived transmissions of HIV and West Nile Virus that occurred despite compliance with existing OPTN policy. These events demonstrated that the previous testing windows could allow recently acquired infections to go undetected before organ recovery, creating an unacceptable risk to transplant recipients.
The Board concluded that waiting for the standard policy development timeline would unnecessarily delay an important patient safety improvement. Acting through emergency authority allows the transplant community to implement this change as quickly as possible while reducing the risk of preventable infectious disease transmission.
I want to recognize the outstanding work of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC), whose members carefully evaluated the available clinical evidence, reviewed donor-derived transmission events, and developed this recommendation with urgency and diligence. Their commitment to improving transplant safety exemplifies the expertise and collaboration that strengthen our national transplant system.
This policy change also reflects the OPTN's broader commitment to continuously evaluating our policies against emerging evidence. When new information identifies opportunities to improve patient outcomes, we have a responsibility to respond. Whether through the standard policy development process or, when circumstances demand, emergency action, our goal remains the same: ensuring that OPTN policies continue to protect transplant recipients while supporting efficient organ donation and transplantation.
Over the coming weeks, the OPTN will provide implementation guidance, educational resources, and operational support to assist organ procurement organizations, transplant hospitals, and living donor recovery hospitals in preparing for this change. We recognize that updating workflows requires coordination across the donation and transplant community, and we appreciate your partnership in implementing this important patient safety enhancement.
On behalf of the OPTN Board of Directors, thank you for your continued commitment to delivering safe, high-quality care to transplant candidates, recipients, living donors, and donor families. Your dedication, together with the ongoing work of our committees and members, ensures that the national transplant system continues to evolve and improve in service of the patients who depend on it.
Sincerely,
John Magee, MD
OPTN President