A prospective multicenter pilot study of HIV-positive deceased donor to HIV-positive recipient kidney transplantation: HOPE in action.
A prospective multicenter pilot study of HIV-positive deceased donor to HIV-positive recipient kidney transplantation: HOPE in action.
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DOI：
10.1111/ajt.16205
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
HOPE in Action Investigators
中科院分区：
文献类型：
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作者：
Durand CM;Zhang W;Brown DM;Yu S;Desai N;Redd AD;Bagnasco SM;Naqvi FF;Seaman S;Doby BL;Ostrander D;Bowring MG;Eby Y;Fernandez RE;Friedman-Moraco R;Turgeon N;Stock P;Chin-Hong P;Mehta S;Stosor V;Small CB;Gupta G;Mehta SA;Wolfe CR;Husson J;Gilbert A;Cooper M;Adebiyi O;Agarwal A;Muller E;Quinn TC;Odim J;Huprikar S;Florman S;Massie AB;Tobian AAR;Segev DL;HOPE in Action Investigators
根据《艾滋病毒器官政策平等法》，美国允许艾滋病毒阳性捐赠者与艾滋病毒阳性接受者(HIV D+/R+)进行移植。为了探索艾滋病毒+供者的安全性和风险，我们进行了一项前瞻性多中心试点研究，比较了艾滋病毒D+/R+供者与艾滋病毒+受体(HIVD−/R+)肾移植(KT)。从2016年3月至2019年7月，在14个中心，有75例艾滋病毒+KTS：25例D+和50例D−(22例来自D−的患者，艾滋病毒检测假阳性)。中位随访期为1.7年。在移植肾1年存活率(91%D+vs 92%D−，P=.9)、1年平均估计肾小球滤过率(63毫升/分钟D+vs 57毫升/分钟D−，P=.31)、艾滋病毒突破(4%D+vs 6%D−，P>；.99)、感染性住院(28%vs 26%，P=.85)或机会性感染(16%vs 12%，P=.72)方面没有死亡或差异。D+受者一年的排斥反应发生率较高(50%vs 29%，HR：1.83，95%CI为0.84~3.95，P=.13)，但差异无统计学意义；去淋巴细胞诱导的排斥反应发生率较低(21%vs 44%，HR：0.33，95%CI 0.21~0.87，P=0.03)。在这项直接比较HIVD+/R+KT和HIVD−/R+KT的多中心先导性研究中，总体移植和HIV预后良好；D+引起更高排斥反应的趋势引发了值得进一步研究的担忧。
HIV-positive donor to HIV-positive recipient (HIV D+/R+) transplantation is permitted in the United States under the HIV Organ Policy Equity Act. To explore safety and the risk attributable to an HIV+ donor, we performed a prospective multicenter pilot study comparing HIV D+/R+ vs HIV-negative donor to HIV+ recipient (HIV D−/R+) kidney transplantation (KT). From 3/2016 to 7/2019 at 14 centers, there were 75 HIV+ KTs: 25 D+ and 50 D− (22 recipients from D− with false positive HIV tests). Median follow-up was 1.7 years. There were no deaths nor differences in 1-year graft survival (91% D+ vs 92% D−, P = .9), 1-year mean estimated glomerular filtration rate (63 mL/min D+ vs 57 mL/min D−, P = .31), HIV breakthrough (4% D+ vs 6% D−, P > .99), infectious hospitalizations (28% vs 26%, P = .85), or opportunistic infections (16% vs 12%, P = .72). One-year rejection was higher for D+ recipients (50% vs 29%, HR: 1.83, 95% CI 0.84–3.95, P = .13) but did not reach statistical significance; rejection was lower with lymphocyte-depleting induction (21% vs 44%, HR: 0.33, 95% CI 0.21–0.87, P = .03). In this multicenter pilot study directly comparing HIV D+/R+ with HIV D−/R+ KT, overall transplant and HIV outcomes were excellent; a trend toward higher rejection with D+ raises concerns that merit further investigation.
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影响因子：
9
作者：
Boyarsky, Brian J.;Segev, Dorry L.
通讯作者：
Segev, Dorry L.
影响因子：
2.1
作者：
Cash, Ayla;Luo, Xun;Durand, Christine M.
通讯作者：
Durand, Christine M.
影响因子：
8.8
作者：
Kucirka, L. M.;Durand, C. M.;Segev, D. L.
通讯作者：
Segev, D. L.
影响因子：
1.7
作者：
Ambaraghassi G;Cardinal H;Corsilli D;Fortin C;Fortin MC;Martel-Laferrière V;Malaise J;Pâquet MR;Rouleau D
通讯作者：
Rouleau D
影响因子：
1.4
作者：
Azar, Marwan M.;Malinis, Maricar F.;Villanueva, Merceditas S.
通讯作者：
Villanueva, Merceditas S.