March 28, 2019
For the first time, a person living with HIV has donated a kidney to a transplant recipient also living with HIV.
A team from Johns Hopkins Medicine in Baltimore performed the surgery March 25.
"A disease that was a death sentence in the 1980s has become one so well-controlled that those living with HIV can now save lives with kidney donation," Dr. Dorry Segev, professor of surgery at the Johns Hopkins University School of Medicine, said Thursday at a news conference.
Organs have been transplanted from an HIV-positive cadaver to an HIV-positive patient; however, HIV is known to cause kidney disease, so people living with HIV have not previously been able to donate kidneys.
Segev said he and his colleagues researched more than 40,000 people living with HIV, looking specifically at kidney health. They found that people whose HIV was under control have the same health risks as those without HIV, and are healthy enough to donate kidneys.
In addition, antiretroviral therapy allows people with HIV to have a normal lifespan.
Stigma of HIV
Dr. Christine Durand, an infectious disease and cancer specialist at Johns Hopkins, said the transplant procedure advances medicine while helping defeat the stigma associated with HIV.
"It challenges providers and the public to see HIV differently," she said. "Every successful transplant shortens the waitlist for all patients, no matter their HIV status."
Durand and Segev are leading HOPE in Action, an effort that encompasses multiple national studies exploring the feasibility, safety and effectiveness of HIV-to-HIV transplantation. Currently, HIV to non-HIV organ donations are not legal.
The donor
The kidney donor, Nina Martinez, has had HIV since early childhood. She decided she wanted to be a donor after watching a TV drama about the first living kidney donor with HIV.
"Some people believe that people living with HIV are sick, or look unwell," said Martinez, who works to eliminate the stigma surrounding HIV. "As a policy advocate, I want people to change what they believe they know about HIV. I don't want to be anyone's hero. I want to be someone's example, someone's reason to consider donating."
After corresponding with Segev, Martinez traveled to Baltimore last year for an evaluation. The surgical team at Johns Hopkins found that Martinez had healthy kidneys and a very low amount of HIV in her blood.
People with well-controlled HIV who don't have a history of diabetes, uncontrolled high blood pressure, or protein in their urine could be healthy enough to donate.
Segev said both the donor and the recipient are doing well. The recipient has asked to remain anonymous.
About 113,000 people are on the transplant waiting list in the United States. The longest wait is for a kidney. About 20 Americans die each day while waiting.