A study by Johns Hopkins Medicine and other institutions shows positive health outcomes for the first three U.S. living HIV-to-HIV kidney transplant donors. The study, published in The Lancet Regional Health—Americas, suggests that HIV-positive individuals who donate a kidney to other HIV-positive individuals have a low risk of developing end-stage kidney disease or other kidney problems post-donation. This research supports the effectiveness of living donations from people with HIV to recipients with HIV. The study was conducted following the enactment of the HIV Organ Policy Equity Act in 2013, which legalized organ donations from HIV-positive individuals to others living with the virus. Science X reported
Study Reveals Positive Health Outcomes for First Three U.S. Living HIV-to-HIV Kidney Transplant Donors
A groundbreaking study has revealed positive health outcomes for the first three living HIV-to-HIV kidney transplant donors in the United States. The study, published in The Lancet Regional Health—Americas, was conducted by researchers at Johns Hopkins Medicine and three collaborating medical institutions.
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Low Risk of Developing Kidney Disease for Donors Living with HIV
The study findings suggest that people living with the human immunodeficiency virus (HIV) who donate a kidney to others living with HIV have a low risk of developing end-stage kidney disease (ESKD) or other kidney problems in the years following the donation. “This new evidence is proof that donating a kidney can be safe for people living with HIV,” says Christine Durand, M.D., associate professor of medicine at Johns Hopkins Medicine and medical director of the Johns Hopkins Transplant Research Center.
HOPE Act Enables Legal Organ Donations from People Living with HIV
The HIV Organ Policy Equity (HOPE) Act, enacted in 2013, enabled people diagnosed with HIV to legally donate organs to others living with the virus as part of approved clinical research studies. The first living donor HIV-to-HIV kidney transplant in the United States under the HOPE Act was done at Johns Hopkins Medicine in March 2019.
Monitoring Long-Term Outcomes of Donors
The study monitored the long-term outcomes of the first three donors, including Nina Martinez, the first-ever U.S. person living with HIV to donate a kidney to another person living with HIV. The donors were monitored for two to four years post-transplant to document and assess their health outcomes.
Addressing Concerns about Kidney Disease Risk
The study addressed concerns that surgical kidney removal might increase the risk of ESKD in living donors with HIV. People living with HIV are known to be at higher risk of kidney disease due to HIV infection, liver toxicity from antiretroviral therapies, hypertension, and diabetes.
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Positive Outcomes for Donors
At two, three, and four years of assessment following donation, all three donors experienced slight decreases in kidney function. However, these changes were expected and comparable to those in kidney donors without HIV. The study authors report that all surgery-related adverse effects were easily managed.
Encouraging More Donations from People Living with HIV
“Hopefully, our findings demonstrating positive outcomes for these three people living with HIV who donated a kidney will encourage other Americans living with HIV to consider living donation,” says Durand. “More organs available for HIV-to-HIV transplants could save hundreds of lives yearly.”
Future Research Needed
While the study’s findings are promising, the researchers caution that the lifetime risk of ESKD in people living with HIV who become living donors remains unknown. To address this concern, more extensive studies with extended periods of following donors are needed.
First Living Donor with HIV Shares Experience
“Knowing the importance of organ donation, I was thrilled that the HOPE Act made it possible for me to become both a registered deceased organ donor and the nation’s first living donor with HIV,” says Martinez. “With the findings from our study and, hopefully, those from research to come, another barrier to living donor HIV-to-HIV kidney transplants is being erased.”
More Information
For more information, refer to the published study: Christine M. Durand et al., Living kidney donors with HIV: experience and outcomes from a case series by the HOPE in Action Consortium, The Lancet Regional Health—Americas (2023). DOI: 10.1016/j.lana.2023.100553
Provided by Johns Hopkins University School of Medicine
the Johns Hopkins University School of Medicine provided this study. For more information, visit their website.
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