ArticleLancet regional health. Americas2023
Living kidney donors with HIV: experience and outcomes from a case series by the HOPE in Action Consortium.
Article in Lancet regional health. Americas, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 12 citations in OpenAlex.
- Hope for kidney transplantation in candidates with human immunodeficiency virus.World journal of transplantation · 2026Review
- Solid organ transplantation in people with HIV: Outcomes, obstacles and opportunities.HIV medicine · 2025Review
- Evaluating Challenges in Access To Transplantation for Persons with HIV.Current HIV/AIDS reports · 2025Review
- Overcoming barriers and stigma: new frontiers in solid organ transplantation for people with HIV.Clinical microbiology reviews · 2024Review
- Non-Standard Risk Donors and Risk of Donor-Derived Infections: From Evaluation to Therapeutic Management.Transplant international : official journal of the European Society for Organ Transplantation · 2024Review
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Authors and funding
21 authors at 6 institutions in 1 country.
Funding
Abstract
Background: Living kidney donation is possible for people living with HIV (PLWH) in the United States within research studies under the HIV Organ Policy Equity (HOPE) Act. There are concerns that donor nephrectomy may have an increased risk of end-stage renal disease (ESRD) in PLWH due to HIV-associated kidney disease and antiretroviral therapy (ART) nephrotoxicity. Here we report the first 3 cases of living kidney donors with HIV under the HOPE Act in the United States. Methods: Within the HOPE in Action Multicenter Consortium, we conducted a prospective study of living kidney donors with HIV. Pre-donation, we estimated the 9-year cumulative incidence of ESRD, performed genetic testing of apolipoprotein L1 (APOL1), excluding individuals with high-risk variants, and performed pre-donation kidney biopsies (HOPE Act requirement). The primary endpoint was ≥grade 3 nephrectomy-related adverse events (AEs) in year one. Post-donation, we monitored glomerular filtration rate (measured by iohexol/Tc-99m DTPA [mGFR] or estimated with serum creatinine [eGFR]), HIV RNA, CD4 count, and ART. Findings: There were three donors with two-four years of follow-up: a 35 year-old female, a 52 year-old male, and a 47 year-old male. Pre-donation 9-year estimated cumulative incidence of ESRD was 3.01, 8.01, and 7.76 per 10,000 persons, respectively. In two donors with APOL1 testing, no high-risk variants were detected. Biopsies from all three donors showed no kidney disease. Post-donation, two donors developed nephrectomy-related ≥grade 3 AEs: a medically-managed ileus and a laparoscopically-repaired incisional hernia. GFR declined from 103 to 84 mL/min/1.73 m Interpretation: The first three living kidney donors with HIV under the HOPE Act in the United States have had promising outcomes at two-four years, providing proof-of-concept to support living donation from PLWH to recipients with HIV. Funding: National Institute of Allergy and Infectious Diseases, National Institutes of Health.
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