1932

Abstract

Implementation of the HIV Organ Policy Equity (HOPE) Act marks a new era in transplantation, allowing organ transplantation from HIV+ donors to HIV+ recipients (HIV D+/R+ transplantation). In this review, we discuss major milestones in HIV and transplantation which paved the way for this landmark policy change, including excellent outcomes in HIV D–/R+ recipient transplantation and success in the South African experience of HIV D+/R+ deceased donor kidney transplantation. Under the HOPE Act, from March 2016 to December 2018, there were 56 deceased donors, and 102 organs were transplanted (71 kidneys and 31 livers). In 2019, the first HIV D+/R+ living donor kidney transplants occurred. Reaching the full estimated potential of HIV+ donors will require overcoming challenges at the community, organ procurement organization, and transplant center levels. Multiple clinical trials are ongoing, which will provide clinical and scientific data to further extend the frontiers of knowledge in this field.

Loading

Article metrics loading...

/content/journals/10.1146/annurev-med-060419-122327
2021-01-27
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/med/72/1/annurev-med-060419-122327.html?itemId=/content/journals/10.1146/annurev-med-060419-122327&mimeType=html&fmt=ahah

Literature Cited

  1. 1. 
    Health Resour. Serv. Adm 2020. Organ donation and transplantation statistics: graph data updated Mar. 2020. https://www.organdonor.gov/statistics-stories/statistics/data.html. Accessed Apr. 2020
  2. 2. 
    Palella FJ Jr, Delaney KM, Moorman AC et al. 1998. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N. Engl. J. Med. 338:853–60
    [Google Scholar]
  3. 3. 
    Wandeler G, Johnson LF, Egger M 2016. Trends in life expectancy of HIV-positive adults on ART across the globe: comparisons with general population. Curr. Opin. HIV AIDS 11:492–500
    [Google Scholar]
  4. 4. 
    Siddiqi AE, Hall HI, Hu X, Song R 2016. Population-based estimates of life expectancy after HIV diagnosis. United States 2008–2011. J. Acquir. Immune Defic. Syndr. 72:230–36
    [Google Scholar]
  5. 5. 
    Antiretroviral Therapy Cohort Collab 2010. Causes of death in HIV-1–infected patients treated with antiretroviral therapy, 1996–2006: collaborative analysis of 13 HIV cohort studies. Clin. Infect. Dis. 50:1387–96
    [Google Scholar]
  6. 6. 
    Halpern S, Ubel P, Caplan A 2002. Solid-organ transplantation in HIV-infected patients. N. Engl. J. Med. 347:284–87
    [Google Scholar]
  7. 7. 
    Kumar MSA, Sierka DR, Damask AM et al. 2005. Safety and success of kidney transplantation and concomitant immunosuppression in HIV-positive patients. Kidney Int 67:1622–29
    [Google Scholar]
  8. 8. 
    Roland M, Barin B, Carlson L et al. 2008. HIV‐infected liver and kidney transplant recipients: 1- and 3‐year outcomes. Am. J. Transplant. 8:355–65
    [Google Scholar]
  9. 9. 
    Stock PG, Barin B, Murphy B et al. 2010. Outcomes of kidney transplantation in HIV-infected recipients. N. Engl. J. Med. 363:2004–14
    [Google Scholar]
  10. 10. 
    Cooper C, Kanters S, Klein M et al. 2011. Liver transplant outcomes in HIV-infected patients: a systematic review and meta-analysis with synthetic cohort. AIDS 25:777–86
    [Google Scholar]
  11. 11. 
    Ragni MV, Eghtesad B, Schlesinger KW et al. 2005. Pretransplant survival is shorter in HIV‐positive than HIV‐negative subjects with end‐stage liver disease. Liver Transplant 11:1425–30
    [Google Scholar]
  12. 12. 
    Trullàs J-C, Cofan F, Barril G et al. 2011. Outcome and prognostic factors in HIV-1–infected patients on dialysis in the cART era: a GESIDA/SEN cohort study. J. Acquir. Immune Defic. Syndr. 57:276–83
    [Google Scholar]
  13. 13. 
    CDC (Cent. Dis. Control) 1981. Kaposi's sarcoma and Pneumocystis pneumonia among homosexual men—New York City and California. Morb. Mortal. Wkly. Rep 30:305–8
    [Google Scholar]
  14. 14. 
    Lewden C, Bouteloup V, De Wit S et al. 2012. All-cause mortality in treated HIV-infected adults with CD4 ≥500/mm3 compared with the general population: evidence from a large European observational cohort collaboration. Int. J. Epidemiol. 41:433–45
    [Google Scholar]
  15. 15. 
    Nakagawa F, Lodwick RK, Smith CJ et al. 2012. Projected life expectancy of people with HIV according to timing of diagnosis. AIDS 26:335–43
    [Google Scholar]
  16. 16. 
    Smith CJ, Ryom L, Weber R et al. 2014. Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration. Lancet 384:241–48
    [Google Scholar]
  17. 17. 
    UNAIDS 2020. Country: South Africa https://www.unaids.org/en/regionscountries/countries/southafrica. Accessed Apr. 2020
  18. 18. 
    Muller E, Kahn D, Mendelson M 2010. Renal transplantation between HIV-positive donors and recipients. N. Engl. J. Med. 362:2336–37
    [Google Scholar]
  19. 19. 
    Muller E, Barday Z, Mendelson M, Kahn D 2012. Renal transplantation between HIV-positive donors and recipients justified. South Afr. Med. J. 102:497–98
    [Google Scholar]
  20. 20. 
    Muller E, Barday Z, Mendelson M, Kahn D 2015. HIV-positive–to–HIV-positive kidney transplantation—results at 3 to 5 years. N. Engl. J. Med. 372:613–20
    [Google Scholar]
  21. 21. 
    CDC (Cent. Dis. Control Prev.) 2020. HIV: basic statistics https://www.cdc.gov/hiv/basics/statistics.html. Accessed Apr. 2020
  22. 22. 
    Locke JE, Gustafson S, Mehta S et al. 2017. Survival benefit of kidney transplantation in HIV-infected patients. Ann. Surg. 265:604–8
    [Google Scholar]
  23. 23. 
    Cohen JB, Locke JE, Shelton B et al. 2019. Disparity in access to kidney allograft offers among transplant candidates with human immunodeficiency virus. Clin. Transplant. 33:e13466
    [Google Scholar]
  24. 24. 
    Boyarsky BJ, Hall EC, Singer AL et al. 2011. Estimating the potential pool of HIV‐infected deceased organ donors in the United States. Am. J. Transplant. 11:1209–17
    [Google Scholar]
  25. 25. 
    Boyarsky BJ, Segev DL. 2016. From bench to bill: how a transplant nuance became 1 of only 57 laws passed in 2013. Ann. Surg. 263:430–33
    [Google Scholar]
  26. 26. 
    113th US Congress 2013. HIV Organ Policy Equity Act. Public Law 113-51. https://www.congress.gov/113/plaws/publ51/PLAW-113publ51.pdf
  27. 27. 
    HRSA (Health Resour. Serv. Adm.), HHS (Dep. Health Hum. Serv.) 2015. Final Human Immunodeficiency Virus Organ Policy Equity (HOPE) Act safeguards and research criteria for transplantation of organs infected with HIV. Fed. Regist 80:73785–96
    [Google Scholar]
  28. 28. 
    HRSA (Health Resour. Serv. Adm.), HHS (Dep. Health Hum. Serv.) 2015. Organ procurement and transplantation: implementation of the HIV Organ Policy Equity Act. Final rule. Fed. Regist 80:26464–67
    [Google Scholar]
  29. 29. 
    Malani P. 2016. HIV and transplantation: new reasons for HOPE. JAMA 316:136–38
    [Google Scholar]
  30. 30. 
    Kucirka LM, Durand CM, Bae S et al. 2016. Induction immunosuppression and clinical outcomes in kidney transplant recipients infected with human immunodeficiency virus. Am. J. Transplant. 16:2368–76
    [Google Scholar]
  31. 31. 
    Redd AD, Quinn TC, Tobian AA 2013. Frequency and implications of HIV superinfection. Lancet Infect. Dis. 13:622–28
    [Google Scholar]
  32. 32. 
    Gottlieb GS, Nickle DC, Jensen MA et al. 2007. HIV type 1 superinfection with a dual-tropic virus and rapid progression to AIDS: a case report. Clin. Infect. Dis. 45:501–9
    [Google Scholar]
  33. 33. 
    Muller E, Barday Z. 2018. HIV-positive kidney donor selection for HIV-positive transplant recipients. J. Am. Soc. Nephrol. 29:1090–95
    [Google Scholar]
  34. 34. 
    Boyarsky B, Durand C, Palella FJ Jr, Segev D 2015. Challenges and clinical decision‐making in HIV‐to‐HIV transplantation: insights from the HIV literature. Am. J. Transplant. 15:2023–30
    [Google Scholar]
  35. 35. 
    Selhorst P, Combrinck CE, Manning K et al. 2019. Longer-term outcomes of HIV-positive–to–HIV-positive renal transplantation. N. Engl. J. Med. 381:1387–89
    [Google Scholar]
  36. 36. 
    Bonny TS, Kirby C, Martens C et al. 2020. Outcomes of donor-derived superinfection screening in HIV-positive to HIV-positive kidney and liver transplantation: a multicentre, prospective, observational study. Lancet HIV 7:E611–19
    [Google Scholar]
  37. 37. 
    Blasi M, Carpenter JH, Balakumaran B et al. 2015. Identification of HIV-1 genitourinary tract compartmentalization by analyzing the env gene sequences in urine. AIDS 29:1651–57
    [Google Scholar]
  38. 38. 
    Marras D, Bruggeman LA, Gao F et al. 2002. Replication and compartmentalization of HIV-1 in kidney epithelium of patients with HIV-associated nephropathy. Nat. Med. 8:522–26
    [Google Scholar]
  39. 39. 
    Canaud G, Dejucq-Rainsford N, Avettand-Fenoël V et al. 2014. The kidney as a reservoir for HIV-1 after renal transplantation. J. Am. Soc. Nephrol. 25:407–19
    [Google Scholar]
  40. 40. 
    Blasi M, Stadtler H, Chang J et al. 2020. Detection of donor's HIV strain in HIV-positive kidney-transplant recipient. N. Engl. J. Med. 382:195–97
    [Google Scholar]
  41. 41. 
    Stock PG, Roland ME, Carlson L et al. 2003. Kidney and liver transplantation in human immunodeficiency virus-infected patients: a pilot safety and efficacy study. Transplantation 76:370–75
    [Google Scholar]
  42. 42. 
    Tan-Tam CC, Frassetto LA, Stock PG 2009. Liver and kidney transplantation in HIV-infected patients. AIDS Rev 11:190–204
    [Google Scholar]
  43. 43. 
    Sawinski D, Goldberg DS, Blumberg E et al. 2015. Beyond the NIH multicenter HIV transplant trial experience: outcomes of HIV+ liver transplant recipients compared to HCV+ or HIV+/HCV+ coinfected recipients in the United States. Clin. Infect. Dis. 61:1054–62
    [Google Scholar]
  44. 44. 
    Alfano G, Mori G, Fontana F et al. 2018. Clinical outcome of kidney transplantation in HIV-infected recipients: a retrospective study. Int. J. STD AIDS 29:1305–15
    [Google Scholar]
  45. 45. 
    Roland ME, Barin B, Huprikar S et al. 2016. Survival in HIV-positive transplant recipients compared with transplant candidates and with HIV-negative controls. AIDS 30:435–44
    [Google Scholar]
  46. 46. 
    HRSA (Health Resour. Serv. Adm.), HHS (Dep. Health Hum. Serv.) 2020. Policy 2: deceased donor organ procurement. Organ Procurement and Transplantation Network (OPTN) Policies https://optn.transplant.hrsa.gov/media/1200/optn_policies.pdf. Accessed May 2020
    [Google Scholar]
  47. 47. 
    Durand CM, Halpern SE, Bowring MG et al. 2018. Organs from deceased donors with false‐positive HIV screening tests: an unexpected benefit of the HOPE Act. Am. J. Transplant. 18:2579–86
    [Google Scholar]
  48. 48. 
    Wilk AR, Hunter RA, McBride MA, Klassen DK 2019. National landscape of HIV+ to HIV+ kidney and liver transplantation in the United States. Am. J. Transplant. 19:92594–605
    [Google Scholar]
  49. 49. 
    Durand CM, Werbel W, Doby B et al. 2020. Clarifying the HOPE Act landscape: the challenge of donors with false‐positive HIV results. Am. J. Transplant. 20:617–19
    [Google Scholar]
  50. 50. 
    Hathorn E, Smit E, Elsharkawy AM et al. 2016. HIV-positive–to–HIV-positive liver transplantation. N. Engl. J. Med. 375:1807–9
    [Google Scholar]
  51. 51. 
    Calmy A, Van Delden C, Giostra E et al. 2016. HIV‐positive‐to‐HIV‐positive liver transplantation. Am. J. Transplant. 16:2473–78
    [Google Scholar]
  52. 52. 
    Ambaraghassi G, Cardinal H, Corsilli D et al. 2017. First Canadian case report of kidney transplantation from an HIV-positive donor to an HIV-positive recipient. Can. J. Kidney Health Dis. 4:2054358117695792
    [Google Scholar]
  53. 53. 
    Varotti G, Dodi F, Boscaneanu A et al. 2019. Kidney transplantation from an HIV‐positive cadaveric donor. Transplant. Infect. Dis. 21:e13183
    [Google Scholar]
  54. 54. 
    Lauterio A, Moioli MC, Di Sandro S et al. 2019. HIV-positive to HIV-positive liver transplantation: to be continued. J. Hepatol. 70:788–89
    [Google Scholar]
  55. 55. 
    Locke JE, Mehta S, Sawinski D et al. 2017. Access to kidney transplantation among HIV-infected waitlist candidates. Clin. J. Am. Soc. Nephrol. 12:467–75
    [Google Scholar]
  56. 56. 
    Muzaale AD, Althoff KN, Sperati CJ et al. 2017. Risk of end‐stage renal disease in HIV‐positive potential live kidney donors. Am. J. Transplant. 17:1823–32
    [Google Scholar]
  57. 57. 
    Johns Hopkins Med 2019. First living donor HIV-to-HIV kidney transplant in the U.S News Release, Mar. 28, Johns Hopkins Med Baltimore, MD: Correction Apr. 11. https://www.hopkinsmedicine.org/news/newsroom/news-releases/first-ever-living-donor-hiv-to-hiv-kidney-transplant-in-the-US
  58. 58. 
    Duke Surgery 2019. Duke performs first HOPE Act HIV+ living donor kidney transplant in N.C. and region. News, Duke University School of Medicine https://surgery.duke.edu/news/duke-performs-first-hope-act-hiv-living-donor-kidney-transplant-nc-and-region
    [Google Scholar]
  59. 59. 
    Botha J, Conradie F, Etheredge H et al. 2018. Living donor liver transplant from an HIV-positive mother to her HIV-negative child: opening up new therapeutic options. AIDS 32:F13–19
    [Google Scholar]
  60. 60. 
    Taha H, Newby K, Das A, Das S 2016. Attitude of patients with HIV infection towards organ transplant between HIV patients. A cross-sectional questionnaire survey. Int. J. STD AIDS 27:13–18
    [Google Scholar]
  61. 61. 
    Lee YC, Hung CC, Cheng A et al. 2016. Willingness of human immunodeficiency virus‐positive patients to donate their organs for transplantation in Taiwan: a cross‐sectional questionnaire survey. Transplant. Infect. Dis. 18:856–61
    [Google Scholar]
  62. 62. 
    Nguyen AQ, Anjum SK, Halpern SE et al. 2018. Willingness to donate organs among people living with HIV. J. Acquir. Immune Defic. Syndr. 79:e30–36
    [Google Scholar]
  63. 63. 
    Bhamidipati D, Veldkamp P, Despines L et al. 2019. A pilot study of organ donor registration among persons living with HIV (PLWH). Am. J. Transplant. 19:Suppl. 3D230 Abstr .)
    [Google Scholar]
  64. 64. 
    Organ Donation Alliance 2020. Recovering organs under the Hope Act: procurement challenges, solutions, and strategies to maximize donors Webinar. https://organdonationalliance.org/tag/hiv/. Accessed May 10, 2020
  65. 65. 
    Donate Life America 2020. Frequently asked questions. Donate Life America https://www.donatelife.net/faq/. Accessed May 10, 202 0
    [Google Scholar]
  66. 66. 
    UNOS (United Netw. Organ Sharing) 2016. Hope Act reminders for OPOs and transplant programs. OPO News Apr. 1. https://unos.org/news/hope-act-reminders-for-opos-and-transplant-programs/
    [Google Scholar]
  67. 67. 
    Cash A, Luo X, Chow EK et al. 2018. HIV+ deceased donor referrals: a national survey of organ procurement organizations. Clin. Transplant. 32:e13171
    [Google Scholar]
  68. 68. 
    Procurement Organ and Transplantation Network, United Network for Organ Sharing 2012. OPTN/UNOS policy notice: eligible death data definitions https://optn.transplant.hrsa.gov/media/2012/opo_policynotice_ie_20130701.pdf. Accessed May 10, 2020
  69. 69. 
    Doby BL, Boyarsky BJ, Gentry S, Segev DL 2019. Improving OPO performance through national data availability. Am. J. Transplant. 19:2675–77
    [Google Scholar]
  70. 70. 
    Durand CM, Segev D, Sugarman J 2016. Realizing HOPE: the ethics of organ transplantation from HIV-positive donors. Ann. Intern. Med. 165:138–42
    [Google Scholar]
  71. 71. 
    Marshall AS, Brewington KM, Allison MK et al. 2017. Measuring HIV-related stigma among healthcare providers: a systematic review. AIDS Care 29:1337–45
    [Google Scholar]
  72. 72. 
    Traino H, Alolod G, Shafer T, Siminoff L 2012. Interim results of a national test of the rapid assessment of hospital procurement barriers in donation (RAPiD). Am. J. Transplant. 12:3094–103
    [Google Scholar]
  73. 73. 
    Stringer KL, Turan B, McCormick L et al. 2016. HIV-related stigma among healthcare providers in the deep south. AIDS Behav 20:115–25
    [Google Scholar]
  74. 74. 
    Van Pilsum Rasmussen SE, Bowring MG, Shaffer AA et al. 2018. Knowledge, attitudes, and planned practice of HIV‐positive to HIV‐positive transplantation in US transplant centers. Clin. Transplant. 32:e13365
    [Google Scholar]
  75. 75. 
    UNOS (United Netw. Organ Sharing) 2020. Pre-implementation notice: extension of HOPE Act participation to all organ types. UNOS News: Policy Changes Apr. 29. https://unos.org/news/policy-changes/hope-act-extension-pre-imp
    [Google Scholar]
  76. 76. 
    HRSA (Health Resour. Serv. Adm.), HHS (Dep. Health Hum. Serv.) 2019. Eliminate the use of DSA and region in kidney allocation policy Proposal overview, Organ Procurement and Transplantation Network Richmond, VA: https://optn.transplant.hrsa.gov/governance/public-comment/eliminate-the-use-of-dsa-and-region-in-kidney-allocation-policy/
  77. 77. 
    UNOS (United Netw. Organ Sharing) 2020. Liver policy updates. UNOS https://unos.org/policy/liver-policy-updates/. Accessed May 10, 2020
    [Google Scholar]
  78. 78. 
    Seaman SM, Van Pilsum Rasmussen SE, Nguyen AQ et al. 2020. Brief report: willingness to accept HIV-infected and increased infectious risk donor organs among transplant candidates living with HIV. J. Acquir. Immune Defic. Syndr. 85:88–92
    [Google Scholar]
/content/journals/10.1146/annurev-med-060419-122327
Loading
/content/journals/10.1146/annurev-med-060419-122327
Loading

Data & Media loading...

  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error