Science Over Stigma: Lessons and Future Direction of HIV-to-HIV Transplantation

Samantha B Klitenic; Macey L Levan; Sarah E Van Pilsum Rasmussen; Christine M Durand

doi:10.1007/s40472-021-00345-y

Science Over Stigma: Lessons and Future Direction of HIV-to-HIV Transplantation

Curr Transplant Rep. 2021;8(4):314-323. doi: 10.1007/s40472-021-00345-y. Epub 2021 Nov 18.

Authors

Samantha B Klitenic¹, Macey L Levan¹, Sarah E Van Pilsum Rasmussen¹, Christine M Durand^{2

3}

Affiliations

¹ Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD USA.
² Department of Medicine and Oncology, Johns Hopkins University School of Medicine, 725 North Wolfe Street/PCTB 228, Baltimore, MD 21205 USA.
³ Sidney Kimmel Cancer Center, Johns Hopkins University School of Medicine, 725 North Wolfe Street, Baltimore, MD 21205 USA.

Abstract

Purpose of review: The HIV Organ Policy Equity (HOPE) Act permits transplantation from donors-with-HIV to recipients-with-HIV (HIV D + /R +). We assess HOPE implementation, summarizing progress and challenges at clinical, legislative, and community levels.

Recent findings: As of July 2021, there have been 300 kidney and 87 liver transplants within HOPE research studies in the USA. Early HIV D + /R + kidney transplant outcomes show excellent patient survival (100%) and graft survival (92%). The number of HOPE donors continues to grow annually but remains lower than projections. State-level policy restrictions are identified in 34 states; however, these do not seem to have impacted practice; 16 states have passed new legislation to facilitate HIV D + /R + transplantation. Stigma related to HIV and low donor registration rates pose additional barriers.

Summary: Early outcomes of HOPE Act transplants are encouraging. Progress to reach full implementation and realize the full benefit of this innovation is ongoing.

Keywords: HIV; HIV Organ Policy Equity Act; HIV transplantation; HIV-positive donor.

Publication types

Review