Kidney Retransplantation Is Associated with Higher Mortality Risk Among HIV+ vs. HIV- Recipients.

B. Shelton,¹ S. Mehta,¹ D. Sawinski,² R. Reed,¹ P. MacLennan,¹ S. Gustafson,³ C. Durand,⁴ D. Segev,⁴ J. Locke.¹

¹School of Medicine, University of Alabama at Birmingham, Birmingham, AL
²School of Medicine, University of Pennsylvania, Philadelphia, PA
³Scientific Registry of Transplant Recipients, Minneapolis, MN
⁴School of Medicine, Johns Hopkins University, Baltimore, MD.

Meeting: 2016 American Transplant Congress

Abstract number: 69

Keywords: HIV virus, Kidney, Outcome, Retransplantation

Session Information

Session Name: Concurrent Session: SOT: HIV, HBV, & HCV

Session Type: Concurrent Session

Date: Sunday, June 12, 2016

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

Presentation Time: 3:06pm-3:18pm

Location: Room 313

Background: Excellent outcomes have been demonstrated in HIV+ kidney transplant (KT) recipients, yet no study has explored outcomes among HIV+ reKT recipients.

Methods: 4,683 adult reKT recipients with known HIV status reported to SRTR (1988-2013). Survival analysis was conducted with date of reKT as the start date. Survival time was compared using Kaplan-Meier curves, and Cox proportional hazards models were used to examine patient survival. Models were adjusted for recipient age, race, HCV status, KDPI, donor type, and transplant year.

Results: HIV+ reKT recipients experienced a 2.7-fold increased risk of death compared to HIV- reKT recipients (aHR: 2.74, 95%CI: 1.68-4.47, p < 0.001). Traditional risk factors remained predictive, with high KDPI grafts conferring a 1.7-fold increased risk of death compared to grafts with a KDPI < 85 (aHR: 1.68, 95%CI: 1.29-2.18, p < 0.001) and 20% lower risk of death experienced by recipients of a living donor compared to recipients of a deceased donor. HCV infection was associated with a 1.7-fold higher risk of death compared to HCV- recipients (aHR: 1.65, 95% CI: 1.30-2.10, p < 0.001).

Conclusions: HIV-infected reKT recipients have increased risk of death compared to their HIV- reKT counterparts. Use of allografts with KDPI > 85% and recipient HCV coinfection are strong predictors of death among HIV+ reKT recipients.

CITATION INFORMATION: Shelton B, Mehta S, Sawinski D, Reed R, MacLennan P, Gustafson S, Durand C, Segev D, Locke J. Kidney Retransplantation Is Associated with Higher Mortality Risk Among HIV+ vs. HIV- Recipients. Am J Transplant. 2016;16 (suppl 3).

To cite this abstract in AMA style:

Shelton B, Mehta S, Sawinski D, Reed R, MacLennan P, Gustafson S, Durand C, Segev D, Locke J. Kidney Retransplantation Is Associated with Higher Mortality Risk Among HIV+ vs. HIV- Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/kidney-retransplantation-is-associated-with-higher-mortality-risk-among-hiv-vs-hiv-recipients/. Accessed May 10, 2025.

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