Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA; email:
Annu Rev Med. 2021 Jan 27;72:107-118. doi: 10.1146/annurev-med-060419-122327.
Implementation of the HIV Organ Policy Equity (HOPE) Act marks a new era in transplantation, allowing organ transplantation from HIV+ donors to HIV+ recipients (HIV D+/R+ transplantation). In this review, we discuss major milestones in HIV and transplantation which paved the way for this landmark policy change, including excellent outcomes in HIV D-/R+ recipient transplantation and success in the South African experience of HIV D+/R+ deceased donor kidney transplantation. Under the HOPE Act, from March 2016 to December 2018, there were 56 deceased donors, and 102 organs were transplanted (71 kidneys and 31 livers). In 2019, the first HIV D+/R+ living donor kidney transplants occurred. Reaching the full estimated potential of HIV+ donors will require overcoming challenges at the community, organ procurement organization, and transplant center levels. Multiple clinical trials are ongoing, which will provide clinical and scientific data to further extend the frontiers of knowledge in this field.
实施艾滋病毒器官政策公平（HOPE）法案标志着移植领域的新时代，允许艾滋病毒阳性供体向艾滋病毒阳性受者（HIV D+/R+ 移植）进行器官移植。在这篇综述中，我们讨论了 HIV 和移植领域的主要里程碑，为这一具有里程碑意义的政策变革铺平了道路，包括 HIV D-/R+ 受者移植的出色结果和南非 HIV D+/R+ 已故供体肾移植的成功。根据 HOPE 法案，从 2016 年 3 月至 2018 年 12 月，有 56 名已故供体，102 个器官被移植（71 个肾脏和 31 个肝脏）。2019 年，首例 HIV D+/R+ 活体供肾移植发生。要充分发挥 HIV+供体的估计潜力，需要克服社区、器官获取组织和移植中心各级的挑战。目前正在进行多项临床试验，这些试验将提供临床和科学数据，进一步拓展该领域的知识前沿。
