A prospective multicenter pilot study of HIV-positive deceased donor to HIV-positive recipient kidney transplantation: HOPE in action

Durand, Christine M.; Zhang, Wanying; Brown, Diane; Yu, Sile; Desai, Niraj M.; Redd, Andrew D.; Bagnasco, Serena M.; Naqvi, Fizza; Seaman, Shanti; Doby, Brianna; Ostrander, Darin; Bowring, Mary G.; Eby, Yolanda; Fernández, Reinaldo E.; Friedman‐Moraco, Rachel; Turgeon, Nicole A.; Stock, Peter G.; Chin‐Hong, Peter; Mehta, Shikha; Stosor, Valentina; Small, Catherine B.; Gupta, Gaurav; Mehta, Sapna A.; Wolfe, Cameron R.; Husson, Jennifer; Gilbert, Alexander; Cooper, Matthew; Adebiyi, Oluwafisayo; Ágarwal, Avinash Kumar; Muller, Elmi; Quinn, Thomas C.; Odim, Jonah; Huprikar, Shirish; Florman, Sander; Massie, Allan B.; Tobian, Aaron A.R.; Segev, Dorry L.

doi:10.1111/ajt.16205

Cited by 75 publications

(87 citation statements)

References 61 publications

(76 reference statements)

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“…These demographic characteristics are similar to those of recipients of HIV D + organs nationally. 21 Of 98 codes identified, 95% were identified in the first 20 interviews, and 100% were identified after the first 30 interviews, suggesting that thematic saturation was reached.…”

Section: Resultsmentioning

confidence: 98%

Patients’ Experiences With HIV-positive to HIV-positive Organ Transplantation

Rasmussen

Seaman

Johnson

et al. 2021

Transplantation Direct

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Background. HIV + donor (HIV D + ) to HIV + recipient (HIV R + ) transplantation involves ethical considerations related to safety, consent, stigma, and privacy, which could be better understood through studying patients’ actual experiences. Methods. We interviewed kidney and liver transplant recipients enrolled in clinical trials evaluating HIV D + /R + transplantation at 4 centers regarding their decision-making process, the informed consent process, and posttransplant experiences. Participants were interviewed at-transplant (≤3 wk after transplant), posttransplant (≥3 mo after transplant), or both time points. Interviews were analyzed thematically using constant comparison of inductive and deductive coding. Results. We conducted 35 interviews with 22 recipients (15 at-transplant; 20 posttransplant; 13 both time points; 85% participation). Participants accepted HIV D + organs because of perceived benefits and situational factors that increased their confidence in the trials and outweighed perceived clinical and social risks. Participants reported positive experiences with the consent process and the trial. Some described HIV-related stigma and emphasized the need for privacy; others believed HIV D + /R + transplantation could help combat such stigma. There were some indications of possible therapeutic misestimation (overestimation of benefits or underestimation of risks of a study). Some participants believed that HIV + transplant candidates were unable to receive HIV-noninfected donor organs. Conclusions. Despite overall positive experiences, some ethical concerns remain that should be mitigated going forward. For instance, based on our findings, targeted education for HIV + transplant candidates regarding available treatment options and for transplant teams regarding privacy and stigma concerns would be beneficial.

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Section: Resultsmentioning

confidence: 98%

Patients’ Experiences With HIV-positive to HIV-positive Organ Transplantation

Rasmussen

Seaman

Johnson

et al. 2021

Transplantation Direct

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“…17,18 Regarding the induction regimen, ATG has more evidence for preventing rejection in HIV-positive kidney transplantation than interleukin-2 (IL-2) receptor antagonists. 7,23,24 In addition, patients who have not received any induction have the highest risk for death and allograft loss. 23 However, the induction regimen should also be based on the immunological risk, infectious risk, pretransplantation CD4+ lymphocyte count, comorbidities, and the patient's frailty.…”

Section: Immunosuppression and Rejectionmentioning

confidence: 99%

The first report of kidney transplantation in a human immunodeficiency virus–positive recipient in Thailand and literature review: Encouragement for developing countries in Southeast Asia

Udomkarnjananun

Naiyarakseree

Townamchai

et al. 2021

SAGE Open Medical Case Reports

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Patients with human immunodeficiency virus infection are at risk of chronic kidney disease and end-stage renal disease. Human immunodeficiency virus infection impedes patients’ accessibility to transplantation in Thailand and other developing countries in Southeast Asia, where the burdens of human immunodeficiency virus infection and chronic kidney disease are rapidly increasing. We report the successful kidney transplantation in a human immunodeficiency virus–positive recipient in Thailand and provide brief information about the current knowledge of human immunodeficiency virus medicine and transplantation that are needed for conducting kidney transplantations in such patients. Patient selection and evaluation, the choice of antiretroviral therapy, immunosuppressive regimens, and infectious complications are reviewed and discussed. The aim is to encourage kidney transplantation in end-stage renal disease patients with well-controlled human immunodeficiency virus infection, especially in countries where the prevalence of human immunodeficiency virus infection is high and the accessibility to transplantation is still limited.

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“…The waitlist for kidney transplantation has exceeded 100 000 patients [3], with only 9.1% of these patients receiving a kidney transplant after 5 years [4]. A novel method to increase the donor pool has been to consider transplanting organs from deceased patients who have had Hepatitis C Virus (HCV) or Human Immunodeficiency Virus (HIV) infections [5,6].…”

Section: Introductionmentioning

confidence: 99%

Economic Considerations in Using HCV and HIV Positive Donors for Kidney Transplant

Bhattacharyya¹,

Friedman²,

Thomas³

et al. 2021

obm transplant

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End Stage Renal Disease is becoming more prevalent in the United States of America, with demand for kidney transplant exceeding the available organ supply. A novel method to increase the donor pool has been to consider transplanting organs from deceased patients who have had Hepatitis C Virus (HCV) or Human Immunodeficiency Virus (HIV) infections. Transplants with HCV infected kidneys are becoming more prevalent, due to increased organ supply due to increased mortality from injection opioid use. Similarly, deceased donor transplants using kidneys infected with HIV have become more common following the passage of the “HIV Organ Policy Equity (HOPE) Act” in 2013. These novel transplant strategies present distinct socioeconomic impacts which differ from those of prior transplant practices. Here, we have reviewed the costs and benefits of receiving a kidney transplant from deceased donors infected with HIV or HCV, compared to receiving a non-viremic kidney transplant.

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A prospective multicenter pilot study of HIV-positive deceased donor to HIV-positive recipient kidney transplantation: HOPE in action

Cited by 75 publications

References 61 publications

Patients’ Experiences With HIV-positive to HIV-positive Organ Transplantation

Patients’ Experiences With HIV-positive to HIV-positive Organ Transplantation

The first report of kidney transplantation in a human immunodeficiency virus–positive recipient in Thailand and literature review: Encouragement for developing countries in Southeast Asia

Economic Considerations in Using HCV and HIV Positive Donors for Kidney Transplant

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