Deceased Donor Kidney Transplantation in a Human Immunodeficiency Virus-Infected Recipient: A Case Report

Transplant Proc. 2019 May;51(4):1187-1189. doi: 10.1016/j.transproceed.2019.01.102. Epub 2019 Feb 8.

Abstract

Human immunodeficiency virus (HIV) infection has traditionally been considered an absolute contraindication for transplantation because immunosuppression will accelerate the disease progression and increase mortality. New antiretroviral agents have given rise to new perspectives and transplantation practices. Now renal transplantation is the gold standard treatment for end-stage renal disease in HIV-infected patients, but increased rejection and toxicity rates and compliance with treatment are important issues. Therefore, patient selection and follow-up should be done carefully in this patient group. Here we present a 51-year-old, male, HIV-infected patient who was diagnosed with HIV at his routine serologic investigation at 2015. Highly active antiretroviral therapy was initiated. One haplotype-matched kidney transplantation from a deceased donor was performed on October 19, 2016. Induction therapy was not administered, and the immunosuppressive regimen included tacrolimus, mycophenolate mofetil, and prednisolone. After 26 months, serum creatinine was 1.1 mg/dL and proteinuria 0.1 g/day. There was no development of donor-specific antibodies. The patient's current HIV viral load remains undetectable (and had been the entire time post-transplantation) while his CD4+ T-cell count currently is 543/mm3.

Publication types

  • Case Reports

MeSH terms

  • Antiretroviral Therapy, Highly Active / methods
  • CD4 Lymphocyte Count
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • Humans
  • Immunocompromised Host*
  • Immunosuppressive Agents / therapeutic use
  • Kidney Failure, Chronic / surgery
  • Kidney Failure, Chronic / virology
  • Kidney Transplantation / methods*
  • Male
  • Middle Aged
  • Viral Load

Substances

  • Immunosuppressive Agents