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Presenter: Elmi, Muller, , South Africa
Authors: Elmi Muller
Summary
The outcome of kidney transplantation in HIV-positive patients receiving kidneys from an HIV-negative donor has been reported as comparable to that of HIV-negative recipients. We now report the 5-7 year outcome of HIV-positive patients who received kidneys from HIV-positive deceased donors.
Methods
We undertook a prospective, nonrandomized study of kidney transplantation in HIV-infected patients who had CD4 T-cell counts of ≥200/mm3 and undetectable plasma HIV RNA levels, on antiretroviral therapy. All patients received kidneys from HIV-infected deceased donors who tested positive with fourth generation ELISA. All donors were either antiretroviral-naive or on a first line regimen.
Results
Between September 2008 and October 2015 a total of 38 HIV-positive patients underwent kidney transplantation. Survivors were followed for a median of 3.4 years. Patient survival rates (± 1SD) at 1- and 3-years was 83.5±0.08% and at 5 years was 74.3±0.11% respectively. The corresponding graft survival rates were 93%, 84% and 84%. A high rejection rate of 15% at 1 year and 22 % at 3 years was observed. HIV infection remained well controlled, with undetectable virus in blood after the transplant.
Conclusions
HIV positive-to-positive kidney transplantation offers an additional treatment modality for HIV-infected patients requiring renal replacement therapy
Objectives
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