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Live Donor (LDTx) HIV(+) Kidney Transplantation Improves Allograft Survival vs. Deceased Donor (CRD) Transplantation.

G. Malat, D. Lee, K. Ranganna, S. Talluri, L. Levin Mizrahi, M. Harhay, C. Culkin, S. Guy.

Drexel University College of Medicine, Philadelphia

Meeting: 2017 American Transplant Congress

Abstract number: D251

Keywords: Donation, HIV virus, Outcome

Session Information

Date: Tuesday, May 2, 2017

Session Name: Poster Session D: Living Donor Kidney Transplant II

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall D1

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  • Longer Pre-Transplant Dialysis Exposure Is More Frequent in Living Donor Kidney Transplantation (LDTX) Involving Lower Income Donor and Recipients and Is Associated with an Increased Risk of LDTX Failure.
  • The Impact of the New Kidney Allocation System on Living Donor Kidney Transplantation(LDTX) Among Patients in the Lowest Quintile of Expected Post-Transplant Survival (EPTS).

Hahnemann University Hospital has performed 113 kidney transplants in HIV(+) recipients. We sought to analyze the impact of HIV(+) LDTx on allograft survival.

Methods: The HIV(+) transplant population was divided into two cohorts: 10 LDTx and 103 CRD. Immunosuppression consisted of antibody induction (basiliximab (n=112), antithymocyte globulin (n=1,CRD), and concomitant IVIG (n=19, 1 LDTx/18 CRD)), calcineurin-inhibitor, antiproliferatives, and prednisone. Rejection rates and outcome data were analyzed.

Results: Key demographics in Table 1. Donor creatinine in LDTx was statistically lower, but comparable calculated KDRI scores with CRD. Despite similar rejection rates (figure 1), and time to first ACR (LDTx 174+134 days vs. CRD 200+311 days, p=0.39), median graft survival was longer with LDTx (figure 2).

Summary: Living kidney donor transplant offers a superior option for kidney transplant candidates with HIV. Efforts to increase living donation for HIV(+) kidney candidates may improve long term outcomes in HIV(+)transplantation.

CRD (n=103) LDTx (n=10) p-value
Recipient Age (years) 48+9 45+6 0.13
Male 85% 90% 0.69
African American 87% 60% 0.38
BMI 25.5+5.1 25.1+5.8 0.73
HCV (+) 42% 20% 0.18
Protease Inhibitor based ART 52% 50% 0.88
KDRI 1.336+0.51 1.195+0.27 0.64
Donor Age (years) 37+15 43+8 0.27
Terminal creatinine (mg/dL) 1.49+1.13 0.83+0.16 0.04
HLA mismatch 4.3+1.5 3.4+2.1 0.24
HLA DR mismatch 1.3+0.7 1.2+0.9 0.77

CITATION INFORMATION: Malat G, Lee D, Ranganna K, Talluri S, Levin Mizrahi L, Harhay M, Culkin C, Guy S. Live Donor (LDTx) HIV(+) Kidney Transplantation Improves Allograft Survival vs. Deceased Donor (CRD) Transplantation. Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Malat G, Lee D, Ranganna K, Talluri S, Mizrahi LLevin, Harhay M, Culkin C, Guy S. Live Donor (LDTx) HIV(+) Kidney Transplantation Improves Allograft Survival vs. Deceased Donor (CRD) Transplantation. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/live-donor-ldtx-hiv-kidney-transplantation-improves-allograft-survival-vs-deceased-donor-crd-transplantation/. Accessed March 8, 2021.

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