A prospective multicenter pilot study of HIV-positive deceased donor to HIV-positive recipient kidney transplantation: HOPE in action.
clinical research/practice
clinical trial
donors and donation: deceased
ethics and public policy
infection and infectious agents
infection and infectious agents - viral: human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)
infectious disease
kidney transplantation/nephrology
law/legislation
rejection
Journal
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
ISSN: 1600-6143
Titre abrégé: Am J Transplant
Pays: United States
ID NLM: 100968638
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
pubmed:
24
7
2020
medline:
22
6
2021
entrez:
24
7
2020
Statut:
ppublish
Résumé
HIV-positive donor to HIV-positive recipient (HIV D+/R+) transplantation is permitted in the United States under the HIV Organ Policy Equity Act. To explore safety and the risk attributable to an HIV+ donor, we performed a prospective multicenter pilot study comparing HIV D+/R+ vs HIV-negative donor to HIV+ recipient (HIV D-/R+) kidney transplantation (KT). From 3/2016 to 7/2019 at 14 centers, there were 75 HIV+ KTs: 25 D+ and 50 D- (22 recipients from D- with false positive HIV tests). Median follow-up was 1.7 years. There were no deaths nor differences in 1-year graft survival (91% D+ vs 92% D-, P = .9), 1-year mean estimated glomerular filtration rate (63 mL/min D+ vs 57 mL/min D-, P = .31), HIV breakthrough (4% D+ vs 6% D-, P > .99), infectious hospitalizations (28% vs 26%, P = .85), or opportunistic infections (16% vs 12%, P = .72). One-year rejection was higher for D+ recipients (50% vs 29%, HR: 1.83, 95% CI 0.84-3.95, P = .13) but did not reach statistical significance; rejection was lower with lymphocyte-depleting induction (21% vs 44%, HR: 0.33, 95% CI 0.21-0.87, P = .03). In this multicenter pilot study directly comparing HIV D+/R+ with HIV D-/R+ KT, overall transplant and HIV outcomes were excellent; a trend toward higher rejection with D+ raises concerns that merit further investigation.
Identifiants
pubmed: 32701209
doi: 10.1111/ajt.16205
pmc: PMC8073960
mid: NIHMS1689804
pii: S1600-6135(22)08539-2
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1754-1764Subventions
Organisme : NIGMS NIH HHS
ID : T32 GM136577
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI138897
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI134591
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI094189
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI120938
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA006973
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.
Références
Clin Kidney J. 2018 Apr;11(2):289-291
pubmed: 29644073
Clin J Am Soc Nephrol. 2017 Mar 7;12(3):467-475
pubmed: 28232406
AIDS. 2010 May 15;24(8):1203-12
pubmed: 20395786
N Engl J Med. 2020 Jan 9;382(2):195-197
pubmed: 31914248
Fed Regist. 2015 May 8;80(89):26464-7
pubmed: 25985481
Transplantation. 2016 Apr;100(4):871-8
pubmed: 26413990
Am J Transplant. 2015 Aug;15(8):2105-16
pubmed: 25976241
Transplantation. 2010 Dec 15;90(11):1172-9
pubmed: 20935597
Int J STD AIDS. 2017 Apr;28(5):447-458
pubmed: 27193421
Can J Kidney Health Dis. 2017 Mar 02;4:2054358117695792
pubmed: 28321326
J Infect Dis. 2012 Jul 15;206(2):267-74
pubmed: 22675216
J Med Virol. 2012 Dec;84(12):1839-43
pubmed: 23080485
Am J Transplant. 2019 Nov;19(11):3058-3070
pubmed: 31207073
Transplantation. 2011 Apr 27;91(8):864-8
pubmed: 21301399
Am J Transplant. 2018 Oct;18(10):2579-2586
pubmed: 29947471
Transpl Immunol. 2016 Sep;38:40-43
pubmed: 27297667
Kidney Int. 2015 Aug;88(2):341-9
pubmed: 25807035
J Immunol. 2003 Apr 15;170(8):4077-86
pubmed: 12682237
J Am Soc Nephrol. 2014 Feb;25(2):407-19
pubmed: 24309185
Transplantation. 2014 Feb 27;97(4):446-50
pubmed: 24162248
Clin Infect Dis. 2015 Mar 15;60(6):941-9
pubmed: 25409471
Am J Transplant. 2019 Dec;19(12):3345-3355
pubmed: 31206243
N Engl J Med. 2010 Nov 18;363(21):2004-14
pubmed: 21083386
Curr Treat Options Infect Dis. 2018 Mar;10(1):107-120
pubmed: 29977166
Ann Surg. 2017 Mar;265(3):604-608
pubmed: 27768622
J Acquir Immune Defic Syndr. 2014 Oct 1;67(2):177-80
pubmed: 25072607
Ann Surg. 2016 Mar;263(3):430-3
pubmed: 26575282
PLoS One. 2011;6(10):e25281
pubmed: 22046237
Clin Transplant. 2019 Feb;33(2):e13466
pubmed: 30578590
Nephrol Dial Transplant. 2014 Jun;29(6):1232-8
pubmed: 23975841
Transplantation. 2017 Sep;101(9):2003-2008
pubmed: 28196049
Lancet Infect Dis. 2013 Jul;13(7):622-8
pubmed: 23726798
Transplantation. 2012 Nov 27;94(10):1020-4
pubmed: 23169224
Am J Transplant. 2015 Aug;15(8):2023-30
pubmed: 26080612
PLoS One. 2010 Dec 10;5(12):e15510
pubmed: 21170322
Int J STD AIDS. 2014 Jan;25(1):57-66
pubmed: 23970634
Am J Transplant. 2009 Aug;9(8):1946-52
pubmed: 19519819
Annu Rev Med. 2011;62:141-55
pubmed: 21090961
Ann Intern Med. 2009 May 5;150(9):604-12
pubmed: 19414839
Clin Transplant. 2018 Feb;32(2):
pubmed: 29222929
J Am Soc Nephrol. 2018 Apr;29(4):1090-1095
pubmed: 29330339
Nephrol Dial Transplant. 2015 Oct;30(10):1734-40
pubmed: 26175146
Clin Transplant. 2018 Oct;32(10):e13365
pubmed: 30074638
J Am Soc Nephrol. 2015 Sep;26(9):2222-9
pubmed: 25791727
J Acquir Immune Defic Syndr. 2011 Aug 1;57(4):276-83
pubmed: 21623213
N Engl J Med. 2019 Oct 3;381(14):1387-1389
pubmed: 31577883
N Engl J Med. 2010 Jun 17;362(24):2336-7
pubmed: 20554994
Am J Transplant. 2016 Aug;16(8):2463-72
pubmed: 26953224
World J Gastroenterol. 2018 Dec 21;24(47):5297-5311
pubmed: 30598575
Biostatistics. 2009 Jan;10(1):1-2
pubmed: 18550565
Immunol Rev. 2013 Jul;254(1):78-101
pubmed: 23772616
Am J Transplant. 2011 Jun;11(6):1209-17
pubmed: 21443677
AIDS. 2016 Jan 28;30(3):435-44
pubmed: 26765937
Am J Transplant. 2016 Aug;16(8):2368-76
pubmed: 27111897
Am J Transplant. 2006 Apr;6(4):753-60
pubmed: 16539632
N Engl J Med. 2015 Feb 12;372(7):613-20
pubmed: 25671253
HIV Med. 2013 Mar;14(3):127-35
pubmed: 22994610
Am J Transplant. 2007 Dec;7(12):2816-20
pubmed: 17949460
Am J Transplant. 2017 Dec;17(12):3114-3122
pubmed: 28696079