Kidney Transplant Noninferior From Donors With Versus Without HIV in HIV-Positive Recipients
By Elana Gotkine HealthDay Reporter
THURSDAY, Oct. 17, 2024 -- Among recipients with HIV, kidney transplantation from donors with HIV is noninferior to that from donors without HIV, according to a study published online Oct. 16 in the New England Journal of Medicine.
Christine M. Durand, M.D., from Johns Hopkins University School of Medicine in Baltimore, and colleagues compared transplantation of kidneys from deceased donors with and without HIV to recipients with HIV. The primary outcome was a safety event (composite of death from any cause, graft loss, serious adverse events, HIV breakthrough event, persistent failure of HIV treatment, or opportunistic infection), assessed for noninferiority.
The researchers enrolled 408 transplantation candidates: 198 received a kidney from a deceased donor, including 99 from a donor with and 99 from a donor without HIV. The adjusted hazard ratio for the composite primary outcome was 1.00 (95 percent confidence interval, 0.73 to 1.38), which demonstrated noninferiority. Overall survival at one and three years, survival without graft loss at one and three years, and rejection at one and three years were similar whether or not the donor had HIV. The groups had a similar incidence of serious adverse events, infections, surgical or vascular complications, and cancer. Recipients of kidneys from donors with HIV had an increased incidence of HIV breakthrough infection (incidence rate ratio, 3.14).
"This multicenter, observational study showed that kidney transplantation from donors with HIV to recipients with HIV is noninferior to kidney transplantation from donors without HIV to recipients with HIV," the authors write.
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Posted October 2024
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