Living Kidney Donation in Individuals with Hepatitis C and HIV Infection: Rationale and Emerging Evidence

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of Review: HIV-infected (HIV+) and hepatitis C virus-infected (HCV+) individuals with end-stage renal disease (ESRD) have decreased access to kidney transplantation. With new opportunities provided by the HIV Organ Policy Equity (HOPE) Act and direct-acting antivirals (DAAs) for HCV, we explore the potential risks and benefits of living-donor kidney transplantation from HIV+ or HCV+ donors from the perspective of both donor health and recipient outcomes. Recent Findings: The HOPE Act permits organ donation from both deceased and living HIV+ persons to HIV+ recipients; however, there is only a clinical experience with HIV+ deceased donors to date. Empirical evidence demonstrates a low but acceptable risk of ESRD in potential HIV+ living donors without comorbidities who have well-controlled infection in the absence of donation. With the availability of potent DAAs for eradication of HCV infection, growing evidence shows good outcomes with HCV-seropositive and/or -viremic deceased kidney donors providing rationale to consider HCV+ living donors. Summary: HIV+ and HCV+ living-donor kidney transplantations may improve access to transplant for vulnerable ESRD populations. Careful evaluation and monitoring are warranted to mitigate potential risks to donors and recipients.

Original languageEnglish (US)
Pages (from-to)167-176
Number of pages10
JournalCurrent Transplantation Reports
Volume6
Issue number2
DOIs
StatePublished - Jun 15 2019

Keywords

  • Direct-acting antivirals
  • HIV
  • HIV Organ Policy Equity Act
  • Hepatitis C
  • Living donor
  • Living-donor transplantation

ASJC Scopus subject areas

  • Transplantation
  • Surgery
  • Hepatology
  • Nephrology
  • Immunology

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