Kidney transplant among people living with HIV safe, shows study
A successful kidney transplant can allow you to live longer.
What you need to know:
- Outdated policies and state laws that criminalise organ donation by people living with HIV as well as stigma are key factors that have for long discouraged individuals living with the virus from becoming organ donors.
People living with HIV can safely receive kidney transplants from deceased donors who had the virus, scientists say in a landmark study that could offer great relieve to kidney failure patients in Kenya and the world at large.
The scientists have confirmed that kidney transplants involving HIV-positive donors and HIV-positive recipients are harmless and are just as effective as organ transplants from people without HIV.
The researchers set out to compare the effectiveness and safety of HIV-to-HIV kidney transplantation for people infected with the virus with procedures involving individuals without Aids.
In the new study published in the New England Journal of Medicine, a total of 198 kidney transplants were analysed.
The subjects had HIV and kidney complications and therefore agreed to receive a kidney from the first available option, be it a deceased HIV-negative donor or a deceased donor without HIV.
Participants who received the organs were observed for not less than four years by the scientists drawn from Baltimore's Johns Hopkins University and NYU Langone Health.
When comparison was made between individuals whose kidneys came from HIV-infected donors and those who received kidneys from HIV-free donors, the researchers got similar results in either case.
The levels of HIV increased among four patients who received kidneys from donors without the virus and also rose among 13 subjects whose kidneys came from HIV-positive donors.
The spike in HIV levels was attributed to patients not taking their medications consistently, but all cases later went back to minimal, undetectable levels.
Scientists are upbeat that the groundbreaking investigation could cut short the painful, long waiting period for kidney transplant for all patients, irrespective of their HIV status, and increase the number of available organs, therefore saving lives.
“It illustrates the fantastic results and safety that these transplants are showing us,” stated Dr Dorry Segev.
The study co-author, Christine Durand, explained that, “expanding kidney transplantation between individuals living with HIV outside the study will be a win-win situation since it would help people living with HIV in need of kidneys by increasing the number of available kidneys from HIV-infected donors alongside more organs donated by individuals without HIV.”
Outdated policies and state laws that criminalise organ donation by people living with HIV as well as stigma are key factors that have for long discouraged individuals living with the virus from becoming organ donors, experts say.
“Apart from helping people living with Aids, we will also allow more organs into the pool, which will enable patients without HIV to get kidneys faster. It is a win-win situation for everybody,” the scientists said.
The study, they added, will have far reaching effects in a number of countries which do not conduct kidney transplantations.
In Kenya, kidney failure patients have to wait for at least two to three years before getting a kidney transplant, according to the Kenya Tissue Transplant Authority (KTTA).
The waiting period can be shorter or longer as it depends on availability of a donor
The waiting time could, however, be shortened if there is a living family member who is a match willing to donate an organ to the patient.
The law allows only single source kidney transplantation from living family donors, who should be the recipient's blood relative up to the fourth generation.
To be a kidney donor, one should be aged between 18 and 65 years, should have the same blood group with the recipient or their blood group should be compatible with the patient.
According to the authority, five million people are estimated to have a type of chronic kidney illness, with a significant number projected to develop kidney failure.
End Stage Kidney Disease patients who needed kidney transplants also known as renal replacement therapy by July last year were 12,500.
Nearly half of Kenyans with kidney disease (6,300) were receiving chronic hemodialysis treatments by October 2022, notes KTTA.
While a large section of kidney patients in the country prefer dialysis treatment because of various factors, kidney transplantation is extremely low.
In a span of one decade, Kenya has only done 708 kidney transplants, between 2012 and 2022, according to KTTA.
Out of 5,700 patients who were on dialysis in 2021, just 160 underwent kidney transplant, translating to 2.8 per cent transplant conversion compared to about 10 per cent globally.
The establishment of KTTA and Human Leukocyte Antigens laboratory at the Kenyatta National Hospital in 2022 was a significant milestone for transplant patients in the country.
Experts recommend kidney transplants for eligible patients since it can raise life expectancy by 20 years and improve the overall quality of a patient’s life.
