In sickness and in health: Living HIV positive kidney donation from a wife to her husband, with 7 years' post-transplant follow-up
In sickness and in health: Living HIV positive kidney donation from a wife to her husband, with 7 years' post-transplant follow-up
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DOI：
10.1111/tid.13171
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发表时间：
2019-12-01
影响因子：
2.6
通讯作者：
Katchman, Eugene
中科院分区：
文献类型：
--
作者：
Grupper, Ayelet;Goykhman, Yaacov;Katchman, Eugene
人类免疫缺陷病毒（HIV）感染历来被认为是肾移植的绝对禁忌症。引入抗逆转录病毒治疗后，几项研究表明，艾滋病毒阴性和艾滋病毒阳性肾受体之间的患者和移植结果相当。2013年，美国国会通过了《艾滋病病毒器官政策公平法案》（HIV Organ Policy Equity Act， HOPE），允许在HIV阳性患者之间进行移植研究。《希望法案》也允许对感染艾滋病毒的人进行活体捐赠。然而，考虑到与艾滋病毒感染相关的肾脏疾病的风险，对艾滋病毒感染者捐赠肾脏的安全性存在担忧。我们在此报告一例于2012年7月在我中心成功进行的hiv阳性活体供体肾移植给hiv阳性受体的病例。据我们所知，这是文献中最早报道的在这种医学背景下完成的病例，因此，可能给移植界带来一些重要的信息。在本病例中，一对感染同一株HIV-1的已婚夫妇进行了活体供体肾移植，双方都接受了有效的抗逆转录病毒治疗，有效抑制了病毒复制，移植前免疫状态令人满意。
Human immunodeficiency virus (HIV) infection was traditionally considered an absolute contraindication for kidney transplantation. After the introduction of ART, several studies have demonstrated comparable patient and graft outcomes between HIV-negative and HIV-positive kidney recipients. The US Congress passed the HIV Organ Policy Equity (HOPE) Act in 2013, which permits research in the area of HIV-positive to HIV-positive transplantation. HIV-infected living donation is also permitted under the HOPE Act. However, there is a concern regarding the safety of kidney donation in an HIV-infected person, given the risk of renal disease associated with HIV infection. We report here the case of successful kidney transplantation from HIV-positive living donor to HIV-positive recipient performed in our center on July 2012. To the best of our knowledge, this is the earliest case done in this medical context to be reported in the literature, therefore, potentially carrying several important messages to the transplantation community. In the present case, the living-donor kidney transplant was performed between a married couple infected with same strain of HIV-1, both on effective ART with efficiently suppressed viral replication and satisfactory pre-transplantation immune status.