HIV associated nephropathy surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD [2]

Overview

Kidney transplantation is increasing in HIV-positive patients with end-stage renal disease (ESRD).^[1] Although the rejection rate is high, the graft survival rates are high.^[2]^[3] Recently reports have shown successful kidney transplantation from HIV-positive donors to HIV-positive recipients.^[4]^[5]

HIV Associated Nephropathy Surgery

Kidney transplantation in HIV-positive patients with end-stage renal disease (ESRD) is increasing.^[1]
A study reported a two to threefold increase in kidney rejection in patients with HIV-positive compared to HIV-negative.^[2].
In one study the incidence of rejection was 31% and 41% at 1 and 3 years, respectively.^[2] In another study the acute rejection rate was 18% and 27% at 1 and 3 years, respectively.^[3]
The high rejection rate require more effective immunotherapy.^[2]
Graft survival rates were 90.4% and 73.7% at 1 and 3 years,^[2] respectively in one study and 100% and 81%, respectively in another study.^[3]
Recently, there have been reports of successful kidney transplantation from HIV-positive donors to HIV-positive recipients.^[4]^[5]
- HIV superinfection and resistance to cART are among the most concerning risks in kidney transplantation in HIV-positive kidneys to HIV-positive recipients.^[6]

References

↑ ^1.0 ^1.1 Palau L, Menez S, Rodriguez-Sanchez J, Novick T, Delsante M, McMahon BA; et al. (2018). “HIV-associated nephropathy: links, risks and management”. HIV AIDS (Auckl). 10: 73–81. doi:10.2147/HIV.S141978. PMC 5975615. PMID 29872351.
↑ ^2.0 ^2.1 ^2.2 ^2.3 ^2.4 Stock PG, Barin B, Murphy B, Hanto D, Diego JM, Light J; et al. (2010). “Outcomes of kidney transplantation in HIV-infected recipients”. N Engl J Med. 363 (21): 2004–14. doi:10.1056/NEJMoa1001197. PMC 3028983. PMID 21083386.
↑ ^3.0 ^3.1 ^3.2 Waheed S, Sakr A, Chheda ND, Lucas GM, Estrella M, Fine DM; et al. (2015). “Outcomes of Renal Transplantation in HIV-1 Associated Nephropathy”. PLoS One. 10 (6): e0129702. doi:10.1371/journal.pone.0129702. PMC 4463848. PMID 26061701.
↑ ^4.0 ^4.1 Muller E, Barday Z, Mendelson M, Kahn D (2015). “HIV-positive-to-HIV-positive kidney transplantation–results at 3 to 5 years”. N Engl J Med. 372 (7): 613–20. doi:10.1056/NEJMoa1408896. PMC 5090019. PMID 25671253.
↑ ^5.0 ^5.1 Durand CM, Segev D, Sugarman J (2016). “Realizing HOPE: The Ethics of Organ Transplantation From HIV-Positive Donors”. Ann Intern Med. 165 (2): 138–42. doi:10.7326/M16-0560. PMC 4949150. PMID 27043422.
↑ Muller E, Barday Z (2018). “HIV-Positive Kidney Donor Selection for HIV-Positive Transplant Recipients”. J Am Soc Nephrol. 29 (4): 1090–1095. doi:10.1681/ASN.2017080853. PMC 5875954. PMID 29330339.

Overview