Hope in Action: A Multicenter Prospective Study of HIV to HIV Kidney Transplantation

C. Durand¹, S. Huprikar², M. Bowring³, D. Brown¹, B. Haydel⁴, N. Desai³, F. Naqvi¹, R. Friedman-Moraco⁵, N. Turgeon⁶, V. Stosor⁷, J. Charette⁷, S. Mehta⁸, J. Husson⁹, A. Gilbert¹⁰, M. Cooper¹¹, C. Butkus-Small¹², G. Gupta¹³, S. Mehta¹⁴, O. Adebiyi¹⁵, P. Chin-Hong¹⁶, P. Stock¹⁷, A. Massie³, S. Florman⁴, D. Segev³

¹Medicine, Johns Hopkins University, Baltimore, MD, ²Medicine, Mount Sinai, New York, NY, ³Surgery, Johns Hopkins University, Baltimore, MD, ⁴Surgery, Mount Sinai, New York, NY, ⁵Medicine, Emory University, Atlanta, GA, ⁶Surgery, Emory University, Atlanta, GA, ⁷Medicine, Northwestern University, Chicago, IL, ⁸Medicine, University of Alabama, Birmingham, AL, ⁹Medicine, University of Maryland, Baltimore, MD, ¹⁰Medicine, Georgetown University, Washington DC, DC, ¹¹Department of Surgery, Georgetown University, Washington DC, DC, ¹²Medicine, Cornell University, New York, NY, ¹³Medicine, Virginia Commonwealth University, Richmond, VA, ¹⁴Medicine, New York University, New York, NY, ¹⁵Medicine, Indiana University, Indianapolis, IN, ¹⁶Medicine, University of California at San Francisco, San Francisco, CA, ¹⁷Surgery, University of California at San Francisco, San Francisco, CA

Meeting: 2019 American Transplant Congress

Abstract number: 20

Keywords: HIV virus, Induction therapy, Kidney transplantation, Rejection

Session Information

Session Name: Concurrent Session: Kidney Donor Selection / Management Issues I

Session Type: Concurrent Session

Date: Sunday, June 2, 2019

Session Time: 2:30pm-4:00pm

Presentation Time: 2:42pm-2:54pm

Location: Ballroom C

*Purpose:

HIV+ donor to HIV+ recipient (HIV D+/R+) kidney transplantation (KT) has had success in South Africa. Expansion of this practice in the US setting of HIV resistance and heterogeneous transplant center practices merits investigation.

*Methods:

We performed a prospective multicenter study comparing KT outcomes between HIV+ recipients of HIV D+ and HIV-uninfected donor (D-) kidneys. Recipients had to have suppressed HIV RNA and CD4>200 cells. Immunosuppression and prophylaxis varied by center.

*Results:

From 3/2016-10/2018, there were 70 kidney transplants at 12 centers: 21 D+/R+, 49 D-/R+ (of which 21 donors had false-positive HIV tests). Recipients were similar with well-controlled HIV(Table1). Survival was 100%. One graft failure (D+/R+, renal vein thrombosis), 1 HIV breakthrough (D-/R+, nonadherence) and 5 opportunistic infections occurred. Rejection was common (D-/R+, n=13, 24%; D+/R+,n=9, 43%, p=0.04) but rejection with hospitalization was rare, particularly for antithymocyte globulin(ATG) recipients(Fig1).

*Conclusions:

Under the HOPE Act, HIV D+/R+ KT has had excellent patient and graft survival with few HIV-related complications. Rejection remains a concern for recipients who did not receive ATG.

To cite this abstract in AMA style:

Durand C, Huprikar S, Bowring M, Brown D, Haydel B, Desai N, Naqvi F, Friedman-Moraco R, Turgeon N, Stosor V, Charette J, Mehta S, Husson J, Gilbert A, Cooper M, Butkus-Small C, Gupta G, Mehta S, Adebiyi O, Chin-Hong P, Stock P, Massie A, Florman S, Segev D. Hope in Action: A Multicenter Prospective Study of HIV to HIV Kidney Transplantation [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/hope-in-action-a-multicenter-prospective-study-of-hiv-to-hiv-kidney-transplantation/. Accessed November 22, 2024.

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