POZ - Treatment News : HIV Infection Shouldn’t Rule Out Kidney Transplantation

People with HIV who received a kidney transplant did almost as well as HIV-negative people of a similar age and better than older HIV-negative transplant recipients, according to a study published November 18 in The New England Journal of Medicine and reported by aidsmap.com.

Despite the significant health benefits of antiretroviral (ARV) therapy, people with HIV remained at an increased risk for end-stage kidney disease compared with HIV-negative people. Early in the epidemic, when less was known about HIV and before the introduction of potent combination ARV therapy, doctors refused to conduct kidney and liver transplants in HIV-positive people. This is because immune suppressive drugs are a used to keep people from rejecting the new organ, and such therapy can potentially increase a person’s risk of worsening his or her HIV disease through the loss of infection fighting CD4 cells.

After ARVs became widely used, and their ability to preserve health and CD4 counts were known, transplant experts reversed their earlier position and began conducting transplants in people with HIV with kidney and liver disease. Subsequently, small studies have indicated that people with HIV who receive transplants do about as well as HIV-negative people, but researchers have continued to study the procedures in hopes of learning how to improve the safety and efficacy of transplants in HIV-positive people.

To more thoroughly understand transplant success in people with HIV, Peter Stock, MD, PhD, from the University of California in San Francisco, and his colleagues tracked 150 HIV-positive people who received kidney transplants between 2003 and 2009 at one of 19 transplant centers in the United States. The average post-transplant follow-up time was 1.7 years, though a significant proportion were followed for three or more years.

At one year following the transplants, only 5 percent died, and just 10 percent suffered organ rejection. After three years of follow-up, 12 percent had died and 27 percent had rejection of their transplanted kidney. These rates are only moderately lower than in HIV-negative people of a similar age, and are actually higher than transplant success rates in HIV-negative people older than 65.

“Kidney transplantation is highly feasible in HIV-infected recipients,” commented the investigators, who also acknowledge that further study and refinement of the use of anti-rejection, immune-suppressive drugs is warranted to improve success rates without putting people at risk for HIV disease progression.

regman, Houston, 2010-11-25 17:55:41
After a number of years of searching from one hospital to another, I was able to find a medical team and hospital that performed my kidney transplant in May of 2009. So far, my kidney has been fuctioning with no problem. The interesting note, however, is that my HIV meds allow me to take less anti-rejection medication, which means I less deterimental side effects.