People living with HIV can now receive liver and kidney transplants from donors who are also HIV positive outside of a research setting, according to a federal rule announced in November.

 

Kidney and liver transplants can be lifesaving, but a shortage of available organs limits access. The HIV Organ Policy Equity (HOPE) Act of 2013 legalized transplants between HIV-positive donors and recipients, but they were allowed only in clinical studies.

 

Positive-to-positive kidney transplants are safe and effective, according to a recent report in The New England Journal of Medicine. In a multicenter observational study of 198 HIV-positive adults with end-stage kidney disease, those who received a kidney from an HIV-positive deceased donor had similar rates of overall survival, graft (organ) survival and rejection events as those who received kidneys from HIV-negative donors. One person appears to have acquired a second genetically distinct strain of HIV from the donor, but there were no notable clinical consequences.

 

The new rule should expand access to transplants for people living with HIV, since organs from HIV-positive donors cannot be given to HIV-negative individuals. This also means people with HIV can donate their organs for others in the HIV community.

 

“Expansion of HIV-to-HIV kidney transplantation outside of research would be a win-win situation,” says study coauthor Christine Durand, MD, of Johns Hopkins University School of Medicine, which performed the first deceased donor kidney and liver transplants under the HOPE Act as well as the first living donor positive-to-positive kidney transplant.