In sickness and in health: Living HIV positive kidney donation from a wife to her husband, with 7 years' post-transplant follow-up

Transpl Infect Dis. 2019 Dec;21(6):e13171. doi: 10.1111/tid.13171. Epub 2019 Sep 26.

Abstract

Human immunodeficiency virus (HIV) infection was traditionally considered an absolute contraindication for kidney transplantation. After the introduction of ART, several studies have demonstrated comparable patient and graft outcomes between HIV-negative and HIV-positive kidney recipients. The US Congress passed the HIV Organ Policy Equity (HOPE) Act in 2013, which permits research in the area of HIV-positive to HIV-positive transplantation. HIV-infected living donation is also permitted under the HOPE Act. However, there is a concern regarding the safety of kidney donation in an HIV-infected person, given the risk of renal disease associated with HIV infection. We report here the case of successful kidney transplantation from HIV-positive living donor to HIV-positive recipient performed in our center on July 2012. To the best of our knowledge, this is the earliest case done in this medical context to be reported in the literature, therefore, potentially carrying several important messages to the transplantation community. In the present case, the living-donor kidney transplant was performed between a married couple infected with same strain of HIV-1, both on effective ART with efficiently suppressed viral replication and satisfactory pre-transplantation immune status.

Keywords: human immunodeficiency virus; kidney transplantation; living kidney donor.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Associated Nephropathy / complications
  • AIDS-Associated Nephropathy / immunology
  • AIDS-Associated Nephropathy / surgery*
  • AIDS-Associated Nephropathy / virology
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / surgery*
  • Anti-HIV Agents / administration & dosage
  • Follow-Up Studies
  • HIV Seropositivity / diagnosis*
  • HIV Seropositivity / drug therapy
  • HIV Seropositivity / virology
  • HIV-1 / isolation & purification
  • Humans
  • Kidney Transplantation / legislation & jurisprudence
  • Kidney Transplantation / methods*
  • Living Donors*
  • Male
  • Middle Aged
  • Preoperative Care / methods
  • Spouses
  • Tissue and Organ Procurement / legislation & jurisprudence
  • Treatment Outcome
  • Viral Load / drug effects
  • Virus Replication / drug effects

Substances

  • Anti-HIV Agents