Kidney transplants between people with HIV are safe, new US study finds

People with HIV can safely receive a kidney from a donor who has died of the virus, according to a major study the U.S. government is working to expand on the practice. It may be shortened by wait for organs For everyone, regardless of HIV status.

The new study, published Wednesday in the New England Journal of Medicine, looked at 198 kidney transplants performed across the United States, and researchers found that the donated organs were infected with the AIDS virus. They found similar results whether or not they came from people who did.

Last month, the Department of Health and Human Services proposed rule changes that would allow this type of kidney and liver transplant outside of research studies. The final rule will apply to both living and deceased donors. If approved, it could come into effect as early as next year.

Participants in this study were HIV-positive and had kidney failure and agreed to receive an organ from either an HIV-positive deceased donor or an HIV-negative deceased donor, whichever kidney became available first.

Researchers followed organ recipients for up to four years. They compared half of the kidneys given by HIV-positive donors to half of the kidneys given by donors without HIV.

Both groups had similarly high overall survival and low organ rejection rates. Viral levels increased in 13 patients in the HIV donor group and in 4 patients in other groups, but most were related to the patients' continued failure to take their HIV medications, and in all cases and returned to very low or undetectable levels.

“This shows the safety and great outcomes that we're seeing from these transplants,” said study co-author Dr. Dolly Segev of New York University Langone Health.

In 2010, South African surgeons provided the first evidence that the use of HIV-positive donor organs in people infected with HIV is safe. However, the practice was not allowed in the United States until 2013, when, at Segev's urging, the government lifted the ban and allowed research. Initially, studies were conducted on deceased donors. Then, in 2019, Segev and colleagues from Johns Hopkins University in Baltimore performed the world's first performance. Kidney transplant from an HIV-infected living donor For HIV-positive recipients.

In total, 500 kidney and liver transplants from HIV-positive donors have been performed in the United States.

Carrie Foote, a sociology professor at Indiana University in Indianapolis, said people living with HIV are discouraged from registering as organ donors due to stigma and outdated state laws and policies that criminalize organ donation to people with HIV. He says he has been actively discouraged.

“Not only can we help those of us living with this disease, but we can also free up more organs across the organ pool, allowing people who don't have HIV to get organs faster.” said Foote, who is HIV positive. Registered organ donor. “It's a win-win for everyone.”

More than 90,000 people are on waiting lists for kidney transplants, according to the U.S. Organ Procurement and Transplant Network. In 2022, more than 4,000 people will die waiting for a kidney.

In an editorial in the same journal, Dr. Elmi Müller of South Africa's Stellenbosch University predicted that the new research would have “widespread implications for many countries that do not transplant these organs.”

“Above all, we have taken another step towards equity and equality for people living with HIV,” wrote Müller, who pioneered the practice.

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