The research, which is the largest comparative trial on the experimental procedure since the first transplant in the US in 2016, further supports the adoption of using organs from HIV-positive donors as standard clinical practice for people with HIV in need of kidney transplantation.
The study, published in the New England Journal of Medicine, analyzed the outcomes of 198 kidney transplantations to people with HIV at 26 medical centers across the US from 2018 to 2021. The findings showed that one-year survival rates for HIV-positive recipients were the same (at 94% and 95%, respectively) for kidney transplants performed using organs from HIV-positive and HIV-negative donors. Three-year survival rates were also similar (at 85% and 87%). Organ rejection rates were also on par after three years (at 21% and 24%).
Other measures for surgical outcomes, including the number of side effects that occurred, were also roughly the same for both groups. While most of the study’s kidney recipients maintained viral suppression of HIV post-transplant, HIV blood counts spiked in 13 patients who received kidneys from donors with HIV. However, these incidences were attributed to recipients not taking their antiviral medications as prescribed, and viral suppression returned with tighter adherence to drug treatment. One superinfection was detected, but with no clinical effects on the organ recipient.
“Our study demonstrates overwhelmingly that kidney transplantation from donors who are HIV positive to HIV-positive recipients is safe and effective,” said study senior investigator and transplant surgeon Dorry Segev, MD, Ph.D. Segev is vice chair in the Department of Surgery at NYU Grossman School of Medicine and director of its Center for Surgical and Transplant Applied Research (C-STAR). Segev also helped draft the HOPE Act and advocated for its passage. His team also performed the first HIV-to-HIV kidney transplantation at Johns Hopkins, where he worked previously.
The HOPE Act, which paved the way for the first efforts to learn if kidney donors with HIV could safely donate to recipients who also tested positive for the virus, was passed by the US Congress in 2013. With the HOPE Act and this multicenter trial, Segev’s research offers clear evidence for moving kidney transplantation in people with HIV from the experimental phase to standard clinical practice and updating guidelines accordingly.
The findings of this study offer hope for the thousands of people with HIV in the US and around the world who are in need of kidney transplantation. The US Department of Health and Human Services proposed policy changes in September to make HIV-to-HIV transplantation the standard of care for both kidney and liver donors. Further research is needed to determine the safety and effectiveness of transplanting other organs, such as the heart and lungs, from HIV-positive donors.
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1.Source: Coherent Market Insights, Public sources, Desk research
2.We have leveraged AI tools to mine information and compile it