HIV+ Living Kidney Donors in the United States: Cases and a Clinical Paradigm
1Surgery, Johns Hopkins University, School of Medicine, Baltimore, MD, 2Duke University Medical Center, Durham, NC, 3Johns Hopkins University, School of Medicine, Baltimore, MD, 4Unaffiliated, N/A, VA, 5Unaffiliated, N/A, GA, 6Duke University, School of Medicine, Durham, NC
Meeting: 2020 American Transplant Congress
Abstract number: 134
Keywords: HIV virus, Kidney, Living donor, Outcome
Session Information
Session Name: Kidney Living Donor: Other I
Session Type: Oral Abstract Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:45pm
Presentation Time: 3:51pm-4:03pm
Location: Virtual
*Purpose: To report clinical characteristics and outcomes of two people living with HIV who underwent laparoscopic donor nephrectomy
*Methods: To facilitate donor selection, we first conducted a longitudinal study of over 40,000 people living with HIV (AJT 2017) to predict risk of ESRD in individuals living with HIV using methods similar to our risk prediction among people without HIV (NEJM 2016). Based on this data-driven risk prediction, OPTN-approved and IRB-approved protocols were initiated at several transplant centers in the US. Data from the two transplant centers that have performed HIV+ living laparoscopic donor nephrectomy in the United states were analyzed .
*Results: A 35-year-old female with a 35-year history of HIV (0.2% lifetime baseline ESRD risk based on the NEJM HIV-negative calculator) and a 52-year-old male with a 10-year history of HIV (1.6% lifetime baseline risk). Both had well-controlled HIV essentially throughout their infection. Both underwent standard donor evaluation as per institutional protocols, with particular attention to nuclear medicine GFR evaluation. Pre-transplant biopsies showed no evidence of HIV-related injury in both donors. Post-donation, both donors remain on pre-donation HIV regimens with good control and post-nephrectomy creatinine changes as expected (0.74 to 1.09 in the donor with 6 months follow-up). One-year donor and recipient outcomes will be available at the time of ATC.
*Conclusions: In the context of growing experience with HIV-to-HIV transplantation, there is strong interest in living donation among the community of people living with HIV. In fact, there is stronger interest in this population than the general population, particularly because of solidarity with the HIV community and a desire to help fellow individuals living with this condition. These two cases provide important proof-of-concept evidence that donation is possible for people living with HIV. Furthermore, the approaches used by both centers for evaluation, selection, informed consent, and follow-up are generalizable to other centers interested in expanding transplantation in this manner.
To cite this abstract in AMA style:
Segev D, Wolfe C, Brown D, Fine D, Neumann K, Martinez N, Ostrander D, Ammary FAl, Tobian A, Baker AW, Durand C. HIV+ Living Kidney Donors in the United States: Cases and a Clinical Paradigm [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/hiv-living-kidney-donors-in-the-united-states-cases-and-a-clinical-paradigm/. Accessed May 9, 2025.« Back to 2020 American Transplant Congress