In all cases, reentry of living donors should occur only after review and approval of the medical director and with the following procedures for each positive analyte:

Hepatitis B surface antigen (HBsAg)

Discard tissue donated at the time of the positive test. After six months, offer to retest the donor. If tests are negative for HBsAg and HBcAb and normal for ALT, donor may be reentered.

Antibody to hepatitis B core antigen (HBcAb)

Discard tissue donated at the time of the positive test. Offer to retest the donor using a fresh blood sample.

1. If tests are negative for HBcAb and HBsAg, and normal for ALT (HBcAb was false positive), donor may be reentered.
2. If HBcAb IgM is negative, HBcAb IgG is positive, HBsAb is positive, HBsAg is negative and ALT is normal (donor is recovered and immune), the donor may be reentered, provided there is no known clinical infection.
3. If HBcAb IgM is positive (recent HBV infection), donor is permanently excluded . All tissue donated since the last negative test must be discarded.

Discard tissue donated since the last negative test. If the confirmatory test is negative, offer to retest the donor after six months. If the test is negative for HCV and ALT is normal, donor may be reentered.

Antibodies to human immunodeficiency virus types 1 and 2 (HIV-1/HIV-2)

Discard tissue donated since the last negative test. If Western blot is negative, donor may be reentered, provided after six months anti-HIV-1/2 (EIA) and Western blot assays are negative.

Antibodies to human T-cell lymphotropic virus types I and II (HTLV-I and HTLV-II)

The serum is tested with Western blot. If Western blot results are negative, donor is acceptable. If Western blot is positive or indeterminate, the donor should be permanently excluded from the program.