HTB

First successful liver transplant from living donor with HIV/HCV coinfection: surgical video online

Simon Collins, HIV i-Base

In March 2023, the journal AIDS included the first case report of a successful liver transplant where the donor was living with both HIV and HCV.

The donor was a mother in South Africa and the recipient was her child. Neither the donor nor the recipient experienced any complication.

This showed that people with well controlled HIV/HCV and without additional risk factors may be suitable to donate part of their healthy liver.

The case is presented in a remarkable short open access video that includes film of the surgery.

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This is an important case given the need for donor organs.
Many of the first reports using HIV positive donors came from South Africa, where HIV prevalence is also high.
The first case of a liver transplant  from a mother living with HIV (no HCV) to her HIV negative child, was in 2018, with good reports out to one year. [2]
Early HIV positive kidney transplants were to HIV positive recopients, also in South Africa. [3]
In the US, legislation in 2016 that finally allowed organ to be donated from people living with HIV, doesn’t allow living donors, only from people who have died. This was the results of a community initiative called the HIV Organ Policy Equity (HOPE) project. [3]

References

  1. Sandro D et al. Successful living donor liver transplantation from an HIV and HCV positive donor: report from the first case in the world. Concise communication. AIDS doi: 10.1097/QAD.0000000000003533. (6 March 2023)
    https://journals.lww.com/aidsonline/Abstract/9900/Successful_living_donor_liver_transplantation_from.220.aspx (web page)
    https://cdn-links.lww.com/permalink/qad/c/qad_2023_02_26_disandro_aids-d-22-00707_sdc3.mp4 (video report)
  2. Botha J et al. Living donor liver transplant from an HIV-positive mother to her HIV-negative childopening up new therapeutic options. AIDS 32(16):p F13-F19. DOI: 10.1097/QAD.0000000000002000. (23 October 2018).
    https://journals.lww.com/aidsonline/Fulltext/2018/10230/Living_donor_liver_transplant_from_an_HIV_positive.1.aspx
  3. Muller E et al. HIV-positive-to-HIV-positive kidney transplantation–results at 3 to 5 years. N Engl J Med. 2015 Feb 12;372(7):613-20. doi: 10.1056/NEJMoa1408896.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5090019/
  4. Durand CM et al. Realizing HOPE: The Ethics of Organ Transplantation From HIV-Positive Donors. Ann Intern Med. 2016 Jul 19;165(2):138-42. doi: 10.7326/M16-0560. Epub 2016 Apr 5.
    https://pubmed.ncbi.nlm.nih.gov/27043422/

 

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