Perceptions of HIV-positive kidney donations to HIV-positive recipients
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BACKGROUND: Kidney transplantation is the preferred standard of care for patients who have both end stage renal disease (ESRD) and human immunodeficiency virus (HIV) infection. The first successful kidney transplant was done in 1954 and the first case of HIV/AIDS occurred in 1981. Until recently, HIV-positive patients who required an organ transplant received an HIV-negative organ because it was illegal to use HIV-positive organs in transplants in the United States. The HIV Organ Policy Equity (HOPE) Act was signed in 2013 and legalized the use of HIV-positive donor organs in organ transplants. The first of these transplants was completed in March 2016 with good results. LITERATURE REVIEW: Renal transplants have lower mortality than dialysis. HIV damages the kidney in multiple ways, including HIV associated nephropathy and HIV immune complex kidney disease, putting HIV patients at higher risk of ESRD. Studies from before the utilization of anti-retroviral therapy show that transplantation of HIV infected blood or organs do not cause failure of the transplanted organ. However, in 1997 most surgeons would not transplant kidneys to HIV-infected individuals. Success of antiretroviral therapy has allowed HIV patients to live longer, but patients experience complications including end organ damage. Providing transplants to ESRD patients with HIV infection has been preferred treatment since 2010. Due to improvements in both HIV and transplant science, transplant specialists today are likely to accept HIV-positive organs to HIV-positive transplant recipients. PROPOSED PROJECT: The proposed study is a survey of United States transplant professionals to determine their perceptions about these transplants. Researchers will collect data in the form of Likert scales as well as open-ended responses. The survey will also collect demographic information about surveyors. Investigators will then analyze the collected data for professional knowledge of the legal change, perceptions of efficacy and safety, and concerns. Researchers will analyze the data both as a whole and divided by demographic subgroups. CONCLUSIONS: To date, there has been no study that has assessed at the attitudes of the medical community involved in these transplants. This study is unique in that it attempts to obtain the perceptions and concerns the transplant specialists have about HIV-positive donor organs to HIV-positive transplant recipients. SIGNIFICANCE: The data from this study will help to establish what opinions are at this time, to determine if there are any regional discrepancies that may affect patient access to care, and to determine the concerns of transplant specialists at this time.