HIV-positive Patients With Kidney Failure Confront Greater Barriers in Receiving Transplant

HIV-infected people with kidney failure are less likely to receive a kidney transplant than uninfected ones a new study of Birmingham School of Medicine at the University of Alabama finds.

“What we know is that individuals in need of kidney transplants are most likely to find living donors from within their own social network, and for HIV-positive patients in need of a kidney transplant, this likely means they will identify potential living donors who are also HIV-positive,” said Jayme Locke, M.D., associate professor in UAB’s Department of Surgery and the study’s lead author. “The HOPE Act now makes it legal for HIV-positive people to donate to HIV-positive recipients, but no HIV-positive person has ever been a living donor. We know HIV-positive persons are at higher risk for kidney disease, and so there is some hesitation in the transplant community to allow HIV-positive persons to be living kidney donors in much the same way we discourage diabetic patients from being living kidney donors. In order to begin safely extending the practice of living donation to HIV-positive persons, we must continue to study risk in otherwise healthy HIV-positive non-donor populations in an effort to identify a subset of HIV-positive persons healthy enough to be living kidney donors. These efforts are the subject of ongoing research by our Comprehensive Transplant Institute Outcomes Research Group here at UAB.”, the study report appeared in the upcoming issue of the Clinical Journal of the American Society of Nephrology says.

Of the 1.2 million HIV-positive in the U. S. more than 30 percent have kidney disease and stay at increased risk of developing kidney failure. Also, such individuals with kidney failure are 19 times more likely to die on dialysis compared with their uninfected counterparts. Kidney transplantation lowers the risk of premature death of such patients by 79 percent compared with receiving dialysis.

“While we understand little is known about the risks HIV-positive persons may incur from donating a kidney, we do see this study as the foundation for demonstrating the significance and need for identifying a subset of HIV-positive persons who are both willing and healthy enough to be living kidney donors such that HIV-positive to HIV-positive living kidney transplantation can be done safely and effectively.”, researchers say.

The study co-authors include Shikha Mehta, M.D., Deirdre Sawinski, M.D. and others.