PMID- 37600163
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240416
IS  - 2667-193X (Electronic)
IS  - 2667-193X (Linking)
VI  - 24
DP  - 2023 Aug
TI  - Living kidney donors with HIV: experience and outcomes from a case series by the 
      HOPE in Action Consortium.
PG  - 100553
LID - 10.1016/j.lana.2023.100553 [doi]
LID - 100553
AB  - BACKGROUND: Living kidney donation is possible for people living with HIV (PLWH) 
      in the United States within research studies under the HIV Organ Policy Equity 
      (HOPE) Act. There are concerns that donor nephrectomy may have an increased risk 
      of end-stage renal disease (ESRD) in PLWH due to HIV-associated kidney disease 
      and antiretroviral therapy (ART) nephrotoxicity. Here we report the first 3 cases 
      of living kidney donors with HIV under the HOPE Act in the United States. 
      METHODS: Within the HOPE in Action Multicenter Consortium, we conducted a 
      prospective study of living kidney donors with HIV. Pre-donation, we estimated 
      the 9-year cumulative incidence of ESRD, performed genetic testing of 
      apolipoprotein L1 (APOL1), excluding individuals with high-risk variants, and 
      performed pre-donation kidney biopsies (HOPE Act requirement). The primary 
      endpoint was >/=grade 3 nephrectomy-related adverse events (AEs) in year one. 
      Post-donation, we monitored glomerular filtration rate (measured by 
      iohexol/Tc-99m DTPA [mGFR] or estimated with serum creatinine [eGFR]), HIV RNA, 
      CD4 count, and ART. FINDINGS: There were three donors with two-four years of 
      follow-up: a 35 year-old female, a 52 year-old male, and a 47 year-old male. 
      Pre-donation 9-year estimated cumulative incidence of ESRD was 3.01, 8.01, and 
      7.76 per 10,000 persons, respectively. In two donors with APOL1 testing, no 
      high-risk variants were detected. Biopsies from all three donors showed no kidney 
      disease. Post-donation, two donors developed nephrectomy-related >/=grade 3 AEs: a 
      medically-managed ileus and a laparoscopically-repaired incisional hernia. GFR 
      declined from 103 to 84 mL/min/1.73 m(2) at four years (mGFR) in donor 1, from 77 
      to 52 mL/min/1.73 m(2) at three years (eGFR) in donor 2, and from 65 to 
      39 mL/min/1.73 m(2) at two years (eGFR) in donor 3. HIV RNA remained <20 
      copies/mL and CD4 count remained stable in all donors. INTERPRETATION: The first 
      three living kidney donors with HIV under the HOPE Act in the United States have 
      had promising outcomes at two-four years, providing proof-of-concept to support 
      living donation from PLWH to recipients with HIV. FUNDING: National Institute of 
      Allergy and Infectious Diseases, National Institutes of Health.
CI  - (c) 2023 The Author(s).
FAU - Durand, Christine M
AU  - Durand CM
AD  - Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, 
      MD, USA.
FAU - Martinez, Nina
AU  - Martinez N
AD  - Donor 1, GA, USA. ORCiD ID: 0000-0003-4686-0674.
FAU - Neumann, Karl
AU  - Neumann K
AD  - Donor 2, VA, USA.
FAU - Benedict, Reed C
AU  - Benedict RC
AD  - Donor 3, IL, USA.
FAU - Baker, Arthur W
AU  - Baker AW
AD  - Division of Infectious Diseases, Department of Medicine, Duke University School 
      of Medicine, Durham, NC, USA.
FAU - Wolfe, Cameron R
AU  - Wolfe CR
AD  - Division of Infectious Diseases, Department of Medicine, Duke University School 
      of Medicine, Durham, NC, USA.
FAU - Stosor, Valentina
AU  - Stosor V
AD  - Divisions of Infectious Diseases and Organ Transplantation, Feinberg School of 
      Medicine, Northwestern University, Chicago, IL, USA.
FAU - Shetty, Aneesha
AU  - Shetty A
AD  - Divisions of Infectious Diseases and Organ Transplantation, Feinberg School of 
      Medicine, Northwestern University, Chicago, IL, USA.
FAU - Dietch, Zachary C
AU  - Dietch ZC
AD  - Divisions of Infectious Diseases and Organ Transplantation, Feinberg School of 
      Medicine, Northwestern University, Chicago, IL, USA.
FAU - Goudy, Leah
AU  - Goudy L
AD  - Divisions of Infectious Diseases and Organ Transplantation, Feinberg School of 
      Medicine, Northwestern University, Chicago, IL, USA.
FAU - Callegari, Michelle A
AU  - Callegari MA
AD  - Divisions of Infectious Diseases and Organ Transplantation, Feinberg School of 
      Medicine, Northwestern University, Chicago, IL, USA.
FAU - Massie, Allan B
AU  - Massie AB
AD  - Department of Surgery, NYU Grossman School of Medicine, New York, NY, USA.
FAU - Brown, Diane
AU  - Brown D
AD  - Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, 
      MD, USA.
FAU - Cochran, Willa
AU  - Cochran W
AD  - Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, 
      MD, USA.
FAU - Muzaale, Abimereki
AU  - Muzaale A
AD  - Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, 
      MD, USA.
FAU - Fine, Derek
AU  - Fine D
AD  - Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, 
      MD, USA.
FAU - Tobian, Aaron A R
AU  - Tobian AAR
AD  - Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, 
      MD, USA.
FAU - Winkler, Cheryl A
AU  - Winkler CA
AD  - Cancer Innovation Laboratory, Center for Cancer Research, NCI and Basic Research 
      Program, Frederick National Laboratories for Cancer Research, Frederick, MD, USA.
FAU - Al Ammary, Fawaz
AU  - Al Ammary F
AD  - Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, 
      MD, USA.
FAU - Segev, Dorry L
AU  - Segev DL
AD  - Department of Surgery, NYU Grossman School of Medicine, New York, NY, USA.
CN  - HOPE in Action Investigators
LA  - eng
GR  - K23 DK129820/DK/NIDDK NIH HHS/United States
GR  - R01 DK131926/DK/NIDDK NIH HHS/United States
PT  - Journal Article
DEP - 20230724
PL  - England
TA  - Lancet Reg Health Am
JT  - Lancet regional health. Americas
JID - 9918232503006676
PMC - PMC10435840
OTO - NOTNLM
OT  - HIV Organ Policy Equity Act
OT  - HIV donation
OT  - HIV to HIV transplantation
OT  - HOPE Act
OT  - Living kidney donation
OT  - Transplantation from donors with HIV to recipients with HIV
COIS- DLS reports serving as a consultant and receiving honoraria for speaking from 
      AstraZeneca, Novavax, Novartis, CareDx, Transmedics, Sanofi, CSL Behring, Jazz 
      Pharmaceuticals, Veloxis, Mallinckrodt, and Thermo Fisher Scientific. CMD reports 
      serving on a grant review committee for Gilead Sciences. AS reports serving on an 
      advisory board for Veloxis Pharmaceuticals. All other authors of this manuscript 
      have no conflicts of interest to disclose as described by The Lancet.
FIR - Agrawal, Neerja
IR  - Agrawal N
FIR - Pereira, Marcus
IR  - Pereira M
FIR - Ranganna, Karthik
IR  - Ranganna K
FIR - Wolfe, Cameron
IR  - Wolfe C
FIR - Friedman-Moraco, Rachel
IR  - Friedman-Moraco R
FIR - Kitchens, William
IR  - Kitchens W
FIR - Adebiyi, Oluwafisayo
IR  - Adebiyi O
FIR - Kubal, Chandrashekhar
IR  - Kubal C
FIR - Cameron, Andrew
IR  - Cameron A
FIR - Desai, Niraj
IR  - Desai N
FIR - Durand, Christine
IR  - Durand C
FIR - Ottmann, Shane
IR  - Ottmann S
FIR - Elias, Nahel
IR  - Elias N
FIR - Gilbert, Alexander
IR  - Gilbert A
FIR - Smith, Coleman
IR  - Smith C
FIR - Castillo-Lugo, Jose A
IR  - Castillo-Lugo JA
FIR - Florman, Sander
IR  - Florman S
FIR - Segev, Dorry L
IR  - Segev DL
FIR - Massie, Allan
IR  - Massie A
FIR - Mehta, Sapna
IR  - Mehta S
FIR - Stosor, Valentina
IR  - Stosor V
FIR - Hand, Jonathan
IR  - Hand J
FIR - Blumberg, Emily
IR  - Blumberg E
FIR - Santos, Carlos Aq
IR  - Santos CA
FIR - Goldberg, Ryan
IR  - Goldberg R
FIR - Mehta, Shikha
IR  - Mehta S
FIR - Cannon, Robert
IR  - Cannon R
FIR - Giorgakis, Emmanouil
IR  - Giorgakis E
FIR - Schaenman, Joanna
IR  - Schaenman J
FIR - Aslam, Saima
IR  - Aslam S
FIR - Stock, Peter
IR  - Stock P
FIR - Price, Jennifer
IR  - Price J
FIR - Apewokin, Senu
IR  - Apewokin S
FIR - Benamu, Esther
IR  - Benamu E
FIR - Spaggiari, Mario
IR  - Spaggiari M
FIR - Baddley, John
IR  - Baddley J
FIR - Morris, Michele I
IR  - Morris MI
FIR - Simkins, Jacques
IR  - Simkins J
FIR - Pruett, Timothy
IR  - Pruett T
FIR - Haidar, Ghady
IR  - Haidar G
FIR - Wojciechowski, David
IR  - Wojciechowski D
FIR - Agarwal, Avinash
IR  - Agarwal A
FIR - Balaraman, Vasanthi
IR  - Balaraman V
FIR - Gupta, Gaurav
IR  - Gupta G
FIR - Chapman, Will
IR  - Chapman W
FIR - Muthukumar, Thangamani
IR  - Muthukumar T
FIR - Small, Catherine B
IR  - Small CB
FIR - Malinis, Maricar
IR  - Malinis M
EDAT- 2023/08/21 06:42
MHDA- 2023/08/21 06:43
PMCR- 2023/07/24
CRDT- 2023/08/21 04:41
PHST- 2023/02/15 00:00 [received]
PHST- 2023/06/22 00:00 [revised]
PHST- 2023/07/03 00:00 [accepted]
PHST- 2023/08/21 06:43 [medline]
PHST- 2023/08/21 06:42 [pubmed]
PHST- 2023/08/21 04:41 [entrez]
PHST- 2023/07/24 00:00 [pmc-release]
AID - S2667-193X(23)00127-8 [pii]
AID - 100553 [pii]
AID - 10.1016/j.lana.2023.100553 [doi]
PST - epublish
SO  - Lancet Reg Health Am. 2023 Jul 24;24:100553. doi: 10.1016/j.lana.2023.100553. 
      eCollection 2023 Aug.