Kidney transplants from HIV positive donors to HIV recipients
17 October 2024. Related: Coinfections and complications, Cancer and HIV.
Simon Collins, HIV i-Base
Results from a prospective US study reported similar successful outcomes from kidney transplants to people living with HIV irrespective of the HIV status of the deceased donor. [1]
The study included 198 adult kidney transplant recipients living with HIV and end-stage kidney disease, with half of donors previously being HIV positive and half HIV negative.
The transplants were between April 2018 and September 2021 with at least three years follow-up.
Outcomes, including overall survival, graft survival, and rejections were similar between the two groups, as were safety results and adverse events. Possible reinfection was reported in one recipient from an HIV donor, but without clinical concerns.
The study was only possible due to new legislation in 2015 called the Hope Act. Before this it was illegal for organs to be transplanted from someone who had HIV, whether living or dead, even with full consent of both the donor and recipient.
The US still does not allow living donors to be people living with HIV.
An analysis from the US HOPS study reported that approximately 6% (281/5215) of people living with HIV in this cohort met the criteria for a kidney (n=258) or liver (n=23) transplant. However, only nine kidney and two liver transplants were performed. [2]
Reference
- Durand et al. Safety of kidney transplantation from donors with HIV under the HOPE Act. New England Journal of Medicine. DOI: 10.1056/NEJMoa2403733. (16 October 2024).
https://www.nejm.org/doi/full/10.1056/NEJMoa2403733 - Mayer CDO et al. Unmet Need for Solid Organ Transplantation Among People With HIV and End-Stage Kidney or Liver Disease: A Brief Report From the HIV Outpatient Study, 2009–2023. JAIDS Journal of Acquired Immune Deficiency Syndromes 97(4):p 397-401. DOI: 10.1097/QAI.0000000000003503. (1 December 2024).
https://journals.lww.com/jaids/abstract/2024/12010/brief_report__unmet_need_for_solid_organ.11.aspx