UAMS performs Arkansas’ first HIV-to-HIV kidney transplant

Health News

Emmanouil Giorgakis (Photo Courtesy: UAMS News)

LITTLE ROCK, Ark. – The University of Arkansas for Medical Sciences has performed the first transplant from an HIV-positive donor to an HIV-positive recipient in the state.

According to a news release by UAMS sent Thursday, Emmanouil Giorgakis, M.D., completed the kidney transplant from a deceased person who had the human immunodeficiency virus in May.

The recipient of the kidney is Richard Poston, 46. According to UAMS officials, Poston was immediately able to stop dialysis treatments he had been receiving three times a week for about three years.

Poston was diagnosed with HIV in 2011 after he developed cryptococcal meningitis, which is an inflammation of the brain and spinal cord membranes. Health officials say the infection attacked his optic nerve, causing him to go blind. In 2018, he started experiencing dizziness and disorientation and needed a cane to walk. UAMS officials say Poston was diagnosed with kidney failure after a trip to the emergency room.

Poston said he did not have qualms about about receiving a kidney from an HIV-positive donor.

“I knew I needed a kidney, and I knew that when you get an organ, the doctors have really looked it over,” Poston said.

Poston said since the transplant last month, he is not experiencing the dizziness that was making it hard for him to function.

“It’s changed my life,” Poston said.

“He’s doing very well,” Giorgakis said.

The transplant was performed as part of a national clinical trial led and sponsored by Johns Hopkins Hospital in Baltimore and made possible by the HIV Organ Policy Equity (HOPE) Act that was passed by Congress in 2013. The law allows transplant teams in the country with approved research protocol to transplant organs from compatible HIV-positive donors to eligible HIV-positive recipients who need a transplant and have agreed to take part in the study.

While the law was enacted in 2013, it did not become effective until November 2015. The first deceased donor HOPE transplants in the United States happened in 2016.

If left untreated, HIV causes acquired immune deficiency syndrome (AIDS), which is a condition that leaves the body defenseless against infections. Improvements in antiretroviral treatments over the years have allowed people with HIV to live normal life spans, according to health officials.

UAMS officials say the hospital is one of 27 transplant centers across the country that are taking part in the HOPE in Action clinical trial. The pilot study evaluates the safety of donating kidneys from HIV-positive deceased donors to HIV-positive recipients.

UAMS operates the only adult liver and kidney transplant program in Arkansas.

UAMS officials note they are also one of 17 transplant centers across the state participating in the HOPE in Action Trial of HIV-positive deceased donor liver transplants for HIV-positive recipients.

The hospital is currently searching for candidates of HIV-positive adults in need of a liver or kidney transplant to be enrolled in the program.

“There are over 120,000 patients on the waiting list for a kidney in the United States, and about 10,000 of those are HIV-positive patients,” Giorgakis said. “HIV-positive patients have a higher risk of kidney failure and carry a three-fold risk of death while on dialysis compared to their HIV-negative counterparts.”

According to Giorgakis, there have been 100 HIV-to-HIV kidney transplants performed across the country during the clinical trial.

“In this multicenter pilot study, so far, overall transplant and HIV outcomes have been excellent, with no HIV breakthrough attributable to receiving an HIV-positive donor kidney,” Giorgakis said. “We have a high prevalence of HIV in the South, which means we have a relatively high number of HIV-positive patients with renal failure, and therefore in need of a lifesaving transplant.”

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