Mortality Rates Have Decreased Positive Outcomes Seen for Kidney Donors With HIV

Research published in The Lancet Regional Health: Americas demonstrates encouraging outcomes for the first living kidney donors with HIV. In a prospective study, Christine M. Durand, MD, and colleagues reported on the first three cases of living kidney donors with HIV. The 9-year cumulative incidence of end-stage renal disease (ESRD) was estimated pre-donation. Grade 3 or greater nephrectomy-related adverse events (AEs) in year 1 were assessed as the primary endpoint. Three donors had 2 to 4 years of follow-up: a woman aged 35, a man aged 52, and a man aged 47. The 9-year estimated cumulative incidence of ESRD was 3.01, 8.01, and 7.76 per 10,000 persons, respectively, pre-donation. Two donors developed nephrectomy-related grade 3 or greater AEs post-donation: a medically managed ileus and a laparoscopically repaired incisional hernia. Glomerular filtration rates decreased from 103 to 84 mL/min/1.73 m2 at 4 years in donor 1, and from 77 to 52 mL/min/1.732, and from 65 to 39 mL/min/1.73 m2 at 3 and 2 years in donors 2 and 3, respectively. In all donors, HIV RNA remained lower than 20 copies/mL and CD4 count remained stable.