HIV-positive Patient Gets Kidney Transplant From HIV-Positive Donor

A kidney donation from an HIV-positive donor to an HIV-positive patient has been successfully performed in Denmark, marking the first time this kind of surgery was performed in that country.

According to a paper published in the journal BMJ Case Reports, the HIV-positive recipient has adapted to the donation "without adverse events." The world's first living-donor HIV to HIV-kidney transplant was performed in the U.S. in 2019 at Johns Hopkins University.

Organs are in great demand, with around 120,000 people around the U.S. waiting for a lifesaving transplant at any given time. Kidneys can be transplanted from living donors, as each person can function on a single kidney, which is a rare opportunity to save a life without the donor having to be dead. Around 20 people die each day waiting for a kidney donation, according to Johns Hopkins University.

The donor and recipient need to have the same tissue and blood types to prevent the body's immune system from rejecting the organ and destroying it, which is why it is most successful with blood relatives.

Until 2013 it was against federal regulations for an HIV-positive person to donate an organ, even if the intended recipient was also HIV-positive. The 2013 HIV Organ Policy Equity Act (HOPE ACT) changed this policy. However, there are regulations in place to ensure that an HIV-positive organ isn't donated to an HIV-negative person.

"If an HIV+ kidney is placed into a negative person there is a very high chance to transmit the virus, since some cells in the kidney may be infected with latent HIV," Elena Martinelli, a research professor at the Feinberg School of Medicine at Northwestern University, told Newsweek.

HIV, or human immunodeficiency virus, is a virus that attacks the body's immune system and white blood cells, leaving the patient vulnerable to infection. HIV may end up causing the disease AIDS (acquired immunodeficiency syndrome), which was an epidemic during the 1980s in the LGBT+ community. It is spread via bodily fluid transfer, both via sex and sharing needles or blood, and has no cure. The symptoms can now be treated better than ever, but HIV-positive people will have the disease for life, according to HIV.gov.

Around 1.2 million people in the U.S. have HIV, and 38 million people worldwide have the condition.

"HIV+ to HIV+ doesn't have that problem, but there are likely very few appropriate HIV+ donors which may explain why this has not been attempted before. Both HIV and drugs can negatively affect the kidneys," Martinelli said.

Including HIV-positive donors in the system will decrease the wait time for all recipients.

"It's important to people who aren't HIV-positive because every time somebody else gets a transplant and gets an organ and gets off the list, your chances get just a little bit better," said Dr. Sander Florman, director of the Recanati/Miller Transplantation Institute at Mount Sinai in New York, told Scientific American in 2019.

According to the authors, the patient has not rejected the organ, and has "good virological control with undetectable HIV RNA, no signs of HIV-associated nephropathy, and no superinfections or opportunistic infections."

Other organs have also been successfully transplanted from HIV-positive donors, including livers and hearts, which were performed for the first time in 2016 and 2022, respectively.