2015 - TID 2015 Conference


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What's New in Transplant ID

5.1 - HIV+ to HIV+ Organ Transplantation (with Spanish Audio Translation)

Presenter: Elmi, Muller, , South Africa
Authors: Elmi Muller

Summary

The outcome of kidney transplantation in HIV-positive patients receiving kidneys from an HIV-negative donor has been reported as comparable to that of HIV-negative recipients. We now report the 5-7 year outcome of HIV-positive patients who received kidneys from HIV-positive deceased donors.

Methods

We undertook a prospective, nonrandomized study of kidney transplantation in HIV-infected patients who had CD4 T-cell counts of ≥200/mm3 and undetectable plasma HIV RNA levels, on antiretroviral therapy. All patients received kidneys from HIV-infected deceased donors who tested positive with fourth generation ELISA. All donors were either antiretroviral-naive or on a first line regimen.

Results

Between September 2008 and October 2015 a total of 38 HIV-positive patients underwent kidney transplantation. Survivors were followed for a median of 3.4 years. Patient survival rates (± 1SD) at 1- and 3-years was 83.5±0.08% and at 5 years was 74.3±0.11% respectively. The corresponding graft survival rates were 93%, 84% and 84%. A high rejection rate of 15% at 1 year and 22 % at 3 years was observed. HIV infection remained well controlled, with undetectable virus in blood after the transplant.

Conclusions

HIV positive-to-positive kidney transplantation offers an additional treatment modality for HIV-infected patients requiring renal replacement therapy 

Objectives

  1. Understand the  impact of a second viral strain on a HIV positive patient
  2. To understand the issue of rejection in HIV positive patients and the outcomes after induction therapy
  3. To understand what HIV Associated nephropathy looks like and to know about  the impact on graft outcomes when using HIV positive donors

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