Blood Transfusions & Organ/Tissue Transplants

Our Nation's Blood Supply

In the early years of the HIV epidemic, blood transfusions were at increased risk for transmitting HIV infection.  In 1985, however, an HIV test became available, and screening of all blood donations rapidly became universal.  The U.S. blood supply is now among the safest in the world:

• All blood donors are prescreened for HIV risk factors.
• Blood donations are required to be tested both for presence of antibodies to HIV and for HIV ribonucleic acid (RNA).  RNA testing detects HIV at an earlier stage than HIV antibody testing.
• Blood and blood products that test positive for HIV are safely discarded and are not used for transfusions. Donors whose blood tests positive for HIV are notified by the collecting agency and are deferred from further donations.

It is important to know that you cannot get HIV from donating blood.  Blood collection procedures are highly regulated and safe.

Do Not Donate Blood to Learn Your HIV Status

Some people think that donating blood is a better way to learn their HIV status than asking their doctor for an HIV test or visiting a clinic. This is not true. You should not donate blood to find out if you are HIV-positive.

Why?  Because the HIV tests used to screen donor blood are highly accurate—but they aren't perfect.  If you have been infected with HIV recently, even the most sensitive test may not show it, and you can infect others if your blood is transfused to them.

If you have engaged in high-risk sexual or drug taking behaviors, you should not donate blood.  It is important, though, to learn your HIV status. You can get an HIV test at a number of places, including your local health department, public health clinic, or doctor’s office or at many local AIDS service organizations, community-based organizations, and even in mobile vans. Visit AIDS.gov’s HIV Testing and Care Services Locator to find a location near you. By getting an HIV test, you can protect your own health, as well as the health of people who need blood!  It is also possible to purchase a rapid home-use HIV test kit.

Testing Donated Blood

The U.S. Food and Drug Administration (FDA), Health Resources and Services Administration (HRSA), National Institutes of Health (NIH), and Centers for Disease Control and Prevention (CDC) have responsibilities related to maintaining the safety of blood, as well as tissues, blood stem cells, and organs. U.S. regulations require that each unit of donated blood is tested for the following infectious agents to ensure its safety:

• Hepatitis B and C viruses (HBV and HCV), which cause inflammation of the liver.
• Human Immunodeficiency viruses (HIV-1 and HIV-2), the viruses that cause AIDS.
• Human T-Lymphotropic Virus (HTLV-1 and HTLV-2), which causes infections that can lead to leukemia or neurologic disease.
• Treponema pallidum, the bacterium that causes syphilis.
• West Nile Virus, a virus spread through the bite of a mosquito that can cause neurologic disease.
• Chagas Disease, a disease that can lead to intestinal dysfunction or cardiac disease. 

For more information, see FDA's Keeping Blood Transfusions Safe and CDC's “How Safe is the Blood Supply in the United States?”

Organ/Tissue Transplants

The risks of transplant-related HIV infection are low. All organ and tissue donors are screened for risk factors, and tested for HIV and other infectious agents that potentially could be transmitted through transplantation. However, although HIV tests are highly accurate, the tests do not always detect the virus in people with very recent infection. Unexpected transmission of HIV, HBV, and HCV from infected donors has been reported in heart, liver, kidney, and pancreas recipients.

Organ Donor Screening

HRSA, a U.S. Public Health Service (PHS) agency, oversees organ procurement and transplantation in the U.S. through its oversight of the Organ Procurement and Transplantation Network (OPTN). OPTN policies require specific screening tests that must be performed in potential organ donors before the organs can be used for transplantation.

According to 2013 PHS guidelines (published in Public Health Reports, Vol. 128, No. 4, July/August 2013 edition), all organ donors, living and deceased, are routinely screened for HIV as well as HBV and HCV. In addition, the guidelines recommend the use of the latest, most sensitive laboratory tests so that patients can be informed of risks to the greatest extent possible and protected from unintentional infections caused by transplanted organs.

Cell and Tissue Donor Screening

FDA regulates human cell and tissue donation. In general, people with risk factors or who test positive for infectious diseases cannot donate cells, tissues, or tissue-based products. All cell and tissue donors are screened and tested for HIV-1 and HIV-2, as well as HBV and HCV. Depending on the type of cell or tissue being donated, some donors are also screened and tested for HTLV-1 and HTLV-2; syphilis; chlamydia; and gonorrhea. In addition, all donors are also screened for risk factors for West Nile Virus and human transmissible spongiform encephalopathy, including Creuztfeldt-Jakob disease.

For more information, see: FDA’s Guidance for Industry: Eligibility Determination for Donors of Human Cells, Tissues, and Cellular and Tissue-Based Products (PDF).