Living Kidney Donations from HIV-Positive Donors


Aug 1, 2023

Living Kidney Donations from HIV-Positive Donors

Living Kidney Donations from HIV-Positive Donors: A HOPE in Action Study

Kidney transplantation has been a crucial intervention for patients with end-stage renal disease. However, with a decline in the number of living kidney donors in recent years, finding suitable matches has become increasingly difficult. A new area of exploration is the acceptance of kidneys from living donors with HIV, made possible under the HIV Organ Policy Equity (HOPE) Act.

The HOPE Act and Its Potential

Enacted in 2013, the HOPE Act allows for organ transplantation from HIV-positive donors to HIV-positive recipients within research studies in the United States. This potentially expands the pool of available organs, but it also raises questions about risks and outcomes related to HIV-associated kidney disease and antiretroviral therapy (ART) nephrotoxicity.

A Pioneering Study: The HOPE in Action Consortium

The HOPE in Action Consortium conducted a prospective study on the first three living kidney donors with HIV in the United States. This research was significant for several reasons:

  1. Rigorous Pre-Donation Assessments: The donors underwent comprehensive pre-donation assessments including estimating the risk of end-stage renal disease (ESRD), genetic testing, and kidney biopsies.
  2. Outcomes and Adverse Events: Two donors experienced nephrectomy-related adverse events, and glomerular filtration rate (GFR) declined in all donors, but HIV-related markers remained stable.
  3. Proof of Concept: The study provided promising outcomes at two to four years, supporting the idea of living kidney donations from HIV-positive individuals to HIV-positive recipients.

Challenges and Ethical Considerations

While the outcomes of the study are encouraging, there are still challenges to address:

  • Medical Challenges: Managing kidney disease and ART-related complications in HIV-positive donors requires specific expertise.
  • Ethical Considerations: Balancing the potential benefits with the associated risks and ensuring informed consent from both donors and recipients are vital.

A Promising Avenue

Living kidney donations from HIV-positive donors represent a new and promising avenue to address the organ shortage. The groundbreaking study by the HOPE in Action Consortium highlights the feasibility of this approach under stringent research protocols. However, further research and adherence to ethical guidelines are needed to fully understand and realize the potential of this innovative approach.

By embracing this new frontier, the medical community can help transform lives while addressing the critical shortage of organ donors. The HOPE Act and subsequent research efforts symbolize the power of science and compassion working together to extend hope to those in need.


Johns Hopkins Comprehensive Transplant Center team performs the first reported HIV-to-HIV living donor kidney transplant in the U.S. Nina Martinez has been living with HIV for most of her life; watch her story as she becomes part of history as the first person living with HIV, donating to a recipient also living with HIV.


Source: Forbes

Nina Martinez is the first HIV + living kidney donor in the US, at Johns Hopkins

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About the Author

Rich Foreman brings over 30 years of technology leadership to his role of CEO and Co-Founder of KidneySoft.  As founding CTO, Rich led the team that developed the CordicoShield / CordicoFire Wellness App. Cordico was honored with the Sacramento Innovation Award in 2021. After achieving a 7 digit ARR, Cordico was acquired by Lexipol in 2020. Rich has a BS in Industrial Engineering from the University of Washington, an MPA from Troy State University and was an officer in the U.S. Navy. Rich co-authored his book, "Tap into the Mobile Economy." Rich's blog was listed in Top 20 Marketing Mobile Blogs of 2014. He has been featured on KCRA3, NEWS10, 1170 Tech AM PowerDrive, Business Radio Money 105.5, SiliconIndia, the Sacramento Business Journal, and the Sacramento Bee. Rich is also the Founding Director of the Sacramento Chapter of Startup Grind and served a term as Utility Commissioner for the City of Folsom. Rich is a regular contributor to and StartupSac. Rich was the Co-founder of Apptology which was named Small Business of the Year in 2014 by the Sacramento Asian Pacific Chamber. He was also the Founding Chief Technology Officer at Cordico. Cordico was acquired by Lexipol in 2020.  Rich also served 4 years as a Naval Officer in the Civil Engineer Corps.

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