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Safety of Kidney Transplantation from Donors with HIV
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Download the PDF here
Download the PDF here
October 16, 2024
N Engl J Med
In this multicenter, noninferiority, observational study involving transplantation candidates with HIV, we found that kidney transplantation from donors with HIV was noninferior to kidney transplantation from donors without HIV with respect to the primary safety outcome (a composite of death from any cause, graft loss, serious adverse event, HIV breakthrough infection, persistent failure of HIV treatment, or opportunistic infection). No meaningful difference was observed between the two groups in terms of overall survival, survival without graft loss, or rejection. Furthermore, the incidence of serious adverse events, infections, surgical or vascular complications, and cancer was similar in the two groups. The occurrence of HIV breakthrough infection was approximately three times as high in the group whose donors had HIV as in the group whose donors did not have HIV, primarily because of nonadherence to antiretroviral therapy. In all participants with HIV breakthrough infection, viral suppression was regained. A single case of potential HIV superinfection or dual infection occurred, without clinical consequences. Taken together, these outcomes support the expansion of kidney transplantation involving donors and recipients with HIV from research to clinical care.
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