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2015 ; 372
(21
): 2070-1
Nephropedia Template TP
N Engl J Med
2015[May]; 372
(21
): 2070-1
PMID25992753
show ga
BACKGROUND: The outcome of kidney transplantation in human immunodeficiency virus
(HIV)?positive patients who receive organs from HIV-negative donors has been
reported to be similar to the outcome in HIV-negative recipients. We report the
outcomes at 3 to 5 years in HIV-positive patients who received kidneys from
HIV-positive deceased donors. METHODS: We conducted a prospective, nonrandomized
study of kidney transplantation in HIV-infected patients who had a CD4 T-cell
count of 200 per cubic millimeter or higher and an undetectable plasma HIV RNA
level. All the patients were receiving antiretroviral therapy (ART). The patients
received kidneys from deceased donors who tested positive for HIV with the use of
fourth-generation enzyme-linked immunosorbent assay at the time of referral. All
the donors either had received no ART previously or had received only first-line
ART. RESULTS: From September 2008 through February 2014, a total of 27
HIV-positive patients underwent kidney transplantation. Survivors were followed
for a median of 2.4 years. The rate of survival among the patients was 84% at 1
year, 84% at 3 years, and 74% at 5 years. The corresponding rates of graft
survival were 93%, 84%, and 84%. (If a patient died with a functioning graft, the
calculation was performed as if the graft had survived.) Rejection rates were 8%
at 1 year and 22% at 3 years. HIV infection remained well controlled, with
undetectable virus in blood after the transplantation. CONCLUSIONS: Kidney
transplantation from an HIV-positive donor appears to be an additional treatment
option for HIV-infected patients requiring renal-replacement therapy. (Funded by
Sanofi South Africa and the Roche Organ Transplantation Research Foundation.)
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