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Kidney Transplantation in HIV-Positive Patients: A Single-Center, 16-Year Experience
Journal article   Peer reviewed

Kidney Transplantation in HIV-Positive Patients: A Single-Center, 16-Year Experience

Gregory E. Malat, Suzanne M. Boyle, Rahul M. Jindal, Stephen Guy, Gary Xiao, Meera N. Harhay, Dong H. Lee, Karthik M. Ranganna, Mysore S. Anil Kumar and Alden M. Doyle
American journal of kidney diseases, v 73(1), pp 112-118
Jan 2019
PMID: 29705074

Abstract

allograft survival antiretroviral therapy (ART) belatacept donor selection end-stage renal disease (ESRD) HIV Organ Policy Equity (HOPE) HIV-positive donor HIV-positive recipient Human immunodeficiency virus (HIV) immunosuppression kidney transplantation Review
Hahnemann University Hospital has performed 120 kidney transplantations in human immunodeficiency virus (HIV)-positive individuals during the last 16 years. Our patient population represents ∼10% of the entire US population of HIV-positive kidney recipients. In our earlier years of HIV transplantation, we noted increased rejection rates, often leading to graft failure. We have established a multidisciplinary team and over the years have made substantial protocol modifications based on lessons learned. These modifications affected our approach to candidate evaluation, donor selection, perioperative immunosuppression, and posttransplantation monitoring and resulted in excellent posttransplantation outcomes, including 100% patient and graft survival at 1 year and patient and graft survival at 3 years of 100% and 96%, respectively. We present key clinical data, including a granular patient-level analysis of the associations of antiretroviral therapy regimens with long-term survival, cellular and antibody-mediated rejection rates, and the causes of allograft failures. In summary, we provide details on the evolution of our approach to HIV transplantation during the last 16 years, including strategies that may improve outcomes among HIV-positive kidney transplantation candidates throughout the United States.

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Collaboration types
Industry collaboration
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Web of Science research areas
Urology & Nephrology
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