(HealthDay News) — Outcomes are encouraging for the first 3 living kidney donors with HIV, according to research published online in The Lancet Regional Health: Americas.
In a prospective study, Christine M. Durand, MD, from the Johns Hopkins University School of Medicine in Baltimore, and colleagues reported on the first 3 cases of living kidney donors with HIV. The 9-year cumulative incidence of end-stage renal disease (ESRD) was estimated predonation and genetic testing of apolipoprotein L1 (APOL1) was performed, excluding individuals with high-risk variants. Grade 3 or greater nephrectomy-related adverse events (AEs) in year 1 were assessed as the primary end point.
The researchers found that 3 donors had 2 to 4 years of follow-up: a 35-year-old woman, a 52-year-old man, and a 47-year-old man. The 9-year estimated cumulative incidence of ESRD was 3.01, 8.01, and 7.76 per 10,000 persons, respectively, predonation. No high-risk variants were detected in 2 donors with APOL1 testing. Two donors developed nephrectomy-related grade 3 or greater AEs postdonation, a medically managed ileus and a laparoscopically repaired incisional hernia. Glomerular filtration rates decreased from 103 to 84 mL/min/1.73 m2 at four years in donor 1 (measured by iohexol/Tc-99m DTPA) and from 77 to 52 mL/min/1.732 and 65 to 39 mL/min/1.73 m2 (estimated with serum creatinine) at three and two years in donors 2 and 3, respectively. In all donors, HIV RNA remained <20 copies/mL and CD4 count remained stable.
“The approach to evaluation and follow-up provides additional transplantation options to benefit both potential donors and recipients with HIV,” the authors write.
Several authors disclosed ties to the pharmaceutical industry.