Kidney Transplantation in a HIV-Positive Recipient

Current state of kidney transplantation in patients with HIV, hepatitis C, and hepatitis B infection

“…Currently, in order to qualify for kidney transplantation, most transplant centers, including ours, utilize the patient selection criteria outlined in the HIV‐TR Study: absence of active infection or malignancy, undetectable viral load (for 16 weeks, though some centers consider patients with 12 weeks of stability), CD4 count > 200 cells/m 3 (though some centers may consider patients with <200 cells/m 3 if viral load is undetectable), on a stable ARV regimen, no history of progressive multifocal leukoencephalopathy, chronic cryptosporidiosis, central nervous system lymphoma, or Kaposi sarcoma 6 …”

“…The longest experience using HIV+ donors comes from South Africa 37‐39 . Muller pioneered transplantation with kidneys from deceased HIV+ donors, using lymphocyte‐depleting induction and tacrolimus‐based immunosuppression 6 . Outcomes have generally been good, with death‐censored graft survival was 93% at 3 years (95% CI 79‐98) and 79% at 5 years (95% CI 58‐91); patient survival was 87% at 3 years (95% CI 74‐94) and 84% at 5 years (95% CI 68‐92) 39 .…”