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

AbstractPurpose of ReviewHIV-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 FindingsThe 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.SummaryHIV+ 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.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research