Scientific letters

HIV-positive kidney transplants for HIV-positive individuals: Attitudes and concerns of South African patients and health care workers

Suzanne Gokool, June Fabian, W D Francois Venter, Catherine MacPhail, Saraladevi Naicker

Abstract


In South Africa, an estimated 30% of the cadaveric donor pool is HIV-infected; in consequence, these organs are discarded. An undersupply of donor organs combined with limited resources, tends to exclude HIV-positive patients from renal replacement programmes. We evaluated the acceptance of using HIV-positive donor kidneys for transplantation into HIV-infected recipients, and found that the vast majority (90% of health care workers and 80% of patients, N=20 and 80, respectively) found this approach acceptable for expanding the organ donor pool, which indicates broad patient and health care worker support for using HIV-infected donor kidneys.Participants: 80 patients were recruited from four different groups: those with HIV on stable antiretroviral (ARV) therapy but with no kidney disease; stable antiretroviral therapy, with kidney disease, including on dialysis; and HIV-uninfected patients, both on dialysis and those with functional kidney transplants. Discussions with 20 health care workers were also conducted.

Results: The vast majority (90% of health care workers and 80% of patients, n=20 and 80 respectively) found transplant of HIV-infected organs to HIV-positive recipients an acceptable method for expanding the organ donor pool. This study found no significant difference between the groups of patients regarding whether they approved of using HIV-positive donors; HIV positive patients were willing to accept kidneys from HIV-infected family members, while HIV-negative patients were very unlikely to accept HIV-infected organs. Health care workers expressed concern about initiatives to expand the donor pool and educate patients concerning transplant eligibility.

Conclusion: These findings indicate broad patient and health care worker support for the use of HIV-infected donor kidneys for some types of renal patients.

Authors' affiliations

Suzanne Gokool, London School of Hygiene and Tropical Medicine

June Fabian, Division of Nephrology, Charlotte Maxeke Johannesburg Hospital, University of Witwatersrand

W D Francois Venter, Reproductive Health and HIV Research Unit, University of Witwatersrand

Catherine MacPhail, Reproductive Health and HIV Research Unit, University of Witwatersrand

Saraladevi Naicker, Division of Nephrology, Charlotte Maxeke Johannesburg Hospital, University of Witwatersrand

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Keywords

End stage renal disease; transplantation; HIV-positive kidney donors; HIV-positive recipients

Cite this article

South African Medical Journal 2010;100(2):96-98.

Article History

Date submitted: 2009-07-13
Date published: 2010-01-29

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