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Kidney transplantation in HIV-positive adults: the UK experience.
|Title||Kidney transplantation in HIV-positive adults: the UK experience.|
|Publication Type||Journal Article|
|Year of Publication||2014|
|Authors||Gathogo EN, Hamzah L, Hilton R, Marshall N, Ashley C, Harber M, Levy JB, Jones R, Boffito M, Khoo SH, Drage M, Bhagani S, Post FA|
|Corporate Authors||UK HIV/Kidney Transplantation Study Group(see appendix)|
|Journal||International journal of STD & AIDS|
|Date Published||2014 Jan|
HIV-positive patients are at increased risk of end-stage kidney disease (ESKD). Kidney transplantation (KT) is an established treatment modality for ESKD in the general population. Recent data have confirmed the feasibility of kidney transplantation in HIV-positive patients, and kidney transplantation is increasingly offered to ESKD patients with well-controlled HIV infection. We report clinical outcomes in a national cohort study of kidney transplantation in HIV-positive patients. In all, 35 HIV-positive KT recipients who had undergone KT up to December 2010 (66% male, 74% black ethnicity) were identified; the median CD4 cell count was 366, all had undetectable HIV RNA levels at kidney transplantation, and 44% received a kidney from a live donor. Patient survival at 1 and 3 years was 91.3%, and graft survival 91.3% and 84.7%, respectively. At one-year post-kidney transplantation, the cumulative incidence of acute rejection was 48%, and the median (IQR) eGFR was 64 (46, 78) mL/min/1.73 m(2). Although HIV viraemia and HIV disease progression were uncommon, renal complications were relatively frequent. Our study corroborates the feasibility of kidney transplantation in HIV-positive patients. The high rates of acute rejection suggest that the optimal immune suppression strategy in this population remains to be refined.
|Alternate Journal||Int J STD AIDS|