A U.S. study has confirmed that kidney transplants between people with HIV are safe, potentially paving the way for more life-saving organ donations. The research, published in the New England Journal of Medicine on Wednesday, could lead to expanded organ transplantation practices and reduce wait times for all patients, regardless of HIV status.
The study examined 198 kidney transplants performed across the U.S., comparing outcomes between recipients who received kidneys from HIV-positive deceased donors and those from HIV-negative donors. Researchers found that both groups experienced similar high survival rates and low levels of organ rejection.
“This demonstrates the safety and the fantastic outcomes that we’re seeing from these transplants,” said Dr. Dorry Segev, co-author of the study from NYU Langone Health.
The participants, all of whom were HIV-positive and had kidney failure, agreed to receive organs from either an HIV-positive or HIV-negative deceased donor, depending on availability. The study tracked the recipients for up to four years. While some patients experienced a rise in viral load — 13 in the HIV donor group and four in the non-HIV donor group — this was largely due to inconsistent adherence to HIV medications. In all cases, viral levels returned to undetectable or very low levels.
The findings come as the U.S. Department of Health and Human Services (HHS) is moving to change regulations to allow kidney and liver transplants between HIV-positive patients outside of research studies. A proposed rule, currently under consideration, would apply to both living and deceased donors and could take effect in the coming year.
Dr. Elmi Muller of Stellenbosch University in South Africa, who pioneered HIV-positive organ transplants, praised the study’s impact in an editorial accompanying the research. She noted that these findings will have “far-reaching effects in many countries that do not perform transplantations with these organs.”
The push to expand HIV-positive organ donation was first initiated in 2013 when the U.S. government lifted a longstanding ban on such transplants for research purposes. This shift followed South Africa’s 2010 success in proving the safety of HIV-positive organ donations. Since then, more than 500 transplants of kidneys and livers from HIV-positive donors have been performed in the U.S.
Despite these advancements, stigma and outdated policies have discouraged people living with HIV from becoming organ donors, said Carrie Foote, a sociology professor at Indiana University in Indianapolis. Foote, who is HIV-positive and a registered organ donor, emphasized the importance of breaking these barriers.
“Not only can we help those of us living with this disease, but we free up more organs in the entire organ pool so that those who don’t have HIV can get an organ faster,” Foote explained. “It’s a win-win for everyone.”
With over 90,000 people currently on the waiting list for kidney transplants in the U.S., this development could significantly reduce wait times. In 2022 alone, more than 4,000 people died waiting for a kidney.
Dr. Muller highlighted the broader impact of the study, stating, “Above all, we have taken yet another step toward fairness and equality for persons living with HIV.”
Gary P Hernal started college at UP Diliman and received his BA in Economics from San Sebastian College, Manila, and Masters in Information Systems Management from Keller Graduate School of Management of DeVry University in Oak Brook, IL. He has 25 years of copy editing and management experience at Thomson West, a subsidiary of Thomson Reuters.
