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J Am Soc Nephrol. 2018 Apr;29(4):1090-1095. doi: 10.1681/ASN.2017080853. Epub 2018 Jan 12.

HIV-Positive Kidney Donor Selection for HIV-Positive Transplant Recipients.

Author information

1
Department of Surgery and elmi.muller@uct.ac.za.
2
Division of Nephrology, Department of Medicine, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, South Africa.

Abstract

The risks associated with transplanting HIV-positive kidneys into HIV-positive recipients have not been well studied. Since 2008, 43 kidneys from 25 HIV-positive deceased donors have been transplanted into patients who are HIV positive in Cape Town, South Africa. Among the donors, 19 (76%) died secondary to trauma. The average age for donors was 34 (interquartile range, 19-52) years old. In some donors, only one kidney was used because of a limited number of suitable recipients on the waiting list. Only two donors had been previously exposed to antiretroviral triple therapy. In 23 of the deceased organ donors, the HIV status was not known before the time of death. Initial concerns about transplanting HIV-positive allografts into HIV-positive recipients in this clinic revolved around the possibility of HIV superinfection. However, all recipients remained virally suppressed several years after the transplant. Only one recipient experienced an increased viral load after the transplant, which was related to a period of noncompliance on her medication. After counseling and improved compliance, the viral load decreased and became suppressed again. Herein, we discuss the findings of this study and review the literature available on this crucial topic.

KEYWORDS:

HIV nephropathy; cadaver organ transplantation; kidney transplantation

PMID:
29330339
PMCID:
PMC5875954
[Available on 2019-04-01]
DOI:
10.1681/ASN.2017080853

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