Accepting organs from HIV-positive donors for HIV-positive patients on the transplant waiting list could help ease the organ shortage, Dr. Hilton and her team note in their report. This would likely result in one or two organ donations from HIV-positive people per year, the researcher said. The study findings was published in the Clinical Kidney Journal
While South African researchers have performed transplants involving HIV-positive donors and recipients with positive results, this was the first time the procedure was done in the UK "To date we have transplanted kidneys from three deceased HIV-infected donors into six HIV-infected patients with end-stage kidney disease , "Dr. Rachel Hilton of Guy's Hospital in London said. "Nevertheless, a deceased person can donate two kidneys and many other organs and tissues, so a single organ donor can save or transform the lives of many other people," she added.
The donor in the new report was a 55-year-old white male who died after a subarachnoid brain hemorrhage . His HIV was under control, with a viral load below 50 copies / ml for the past three years and a CD4 cell count above 200 cells mm3 for the past six years. The recipients were a 60-year-old Black Caribbean male who had been on the deceased waiting list for 563 days, and a 45-year-old Black Caribbean male who had been on the list for 306 days.
Patient 1 required dialysis after transplant when I developed oliguric delayed graft function . At day 5, a kidney biopsy found acute T-cell-mediated rejection and arteritis. I have responded well to 10 days of antithymocyte globulin, with kidney function improving to an estimated glomerular filtration rate (eGFR) of 38 ml / minute. The allograft functioned immediately in patient 2, who was discharged from the hospital eight days after the procedure. His corrected eGFR is now 56 ml / min.
Two years after transplant, both patients are well and have undergone HIV control, and have not required changes to their antiretroviral regimen. "Modern highly effective antiretroviral therapy has transformed the lives of people infected with HIV so that this is now a chronic manageable disease, like, for example, diabetes," Dr. Hilton said. "This in turn opens up the opportunity for people living with HIV to have access to such treatments as organ transplantation and the opportunity to donate their organs after death."
Dr. Hilton added: "Our program is still in its infancy so we would like to have confidence that longer-term outcomes for these recipients remain favorable. My hope for the future however is that newer antiretroviral agents , particularly those with few or no interactions with current immunosuppressive regimens , will enable even better outcomes for HIV-infected transplant recipients . "