Introduction:

HIV+ individuals can be transplanted safely and effectively but face additional barriers in evaluation and listing.

Methods

We performed a single center chart review of all HIV+ patients who were evaluated for kidney transplant from June 2009 to August 2015 in order to better understand the process and timing of HIV+ individual kidney transplant evaluation. We described reasons of failure for listing.

Results

Ninety-nine HIV+ patients were evaluated for kidney transplant. The median age of the cohort was 50 years old and 87% were African-American. At the time of evaluation, 92% were already receiving dialysis for a median of close to two years (709 days, IQR 129, 1885). Eighty-four (87%) had controlled HIV viremia. One third (33%) of patients evaluated were ultimately activated and of these, seven received kidney transplantation. Median time from evaluation to listing was 136 days (IQR 75, 379). Three out of ten (29%) were denied. Reasons for failure of listing include; inability to complete work up (n=8, 27.6%), positive drug screen (n=7, 24.2%), death (n=3, 10%), severe illness (n=3, 10%) and uncontrolled viremia (n=3, 10%).

Discussion

In our cohort, the majority of HIV+ patients who were evaluated for kidney transplantation were on dialysis at the time of initial presentation. Their HIV infection was also well controlled. We found a disproportionate number of patients who were unable to complete work up, had significant psychosocial barriers, or were engaged in active substance abuse. Care providers should focus on improving earlier referral for HIV+ patients with kidney failure, and centers that evaluate HIV+ individuals should be aware of their unique barriers to transplantation.

CITATION INFORMATION: Lee D, Aldea A, Harhay M, Akshay S, Malat G, Law N, DeBellis S, Bias T, Boyle S, Ranganna K, Doyle A. Impediments to Timely Listing for HIV+ Patients Being Evaluated for Kidney Transplantation. Am J Transplant. 2016;16 (suppl 3).

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