Posted on Thursday 5 May 2016
Martin Drage, transplant surgeon, and Rachel Hilton, kidney specialist, lead the Trust's work in HIV kidney transplants.
The UK’s first successful kidney transplants from an HIV-positive donor to two HIV-positive recipients have taken place at Guy’s and St Thomas’.
The pioneering procedures were undertaken at Guy’s Hospital in 2015 and both transplanted kidneys are working well for the two recipients, who wish to remain anonymous.
Having confirmed the success of the transplants, Guy’s and St Thomas’ kidney experts are now sharing these results to encourage others living with HIV to join the NHS Organ Donor Register.
Dr Rachel Hilton, consultant nephrologist at Guy’s and St Thomas’, says: “These successful kidney transplants represent an important breakthrough.
“Previously organs from deceased patients with HIV were lost because it was not known whether it would be safe or effective to use those organs. We now know that we can accept organs from deceased patients with well-controlled HIV, to give to other HIV-infected patients on the transplant waiting list. Often those patients are in desperate need for a donated organ and this initiative means that they may be transplanted more quickly, which helps everyone waiting on the list.
“Advances in the way that HIV is managed and treated mean that someone can live an otherwise healthy life with the condition. The principal health concern our patients faced was their kidney failure and without these transplants their life expectancy would be dramatically lower.
“Learning from the examples set in other parts of the world, we used a transplant technique that ensured the kidneys were compatible between donor and recipient and it gives us great pleasure to confirm that the transplants were a success and both patients are doing well.”
Two functioning kidneys were donated by a deceased donor who had HIV and were transplanted into two patients with HIV who had kidney disease.
All potential organ donors are tested for a number of infections, including HIV, and at present organs from donors with HIV can only go to a recipient who also has HIV.
Guy’s and St Thomas’ is among a handful of centres providing kidney transplantation in patients with HIV. The Trust has the largest experience in the UK of kidney transplantation in this group of patients.
Before being put forward for transplants the patients were carefully assessed by a team of experts at the Trust, including a consultant physician for HIV, a specialist pharmacist, and kidney surgeons. The risks and benefits were fully explained to the patients before they chose to go ahead with the procedures.
Following the surgery, this team of experts closely monitored the patients’ response to antiretroviral therapies and immunosuppression drugs to ensure that the transplants were properly accepted by the recipients’ bodies.
Mr Martin Drage, transplant surgeon at Guy’s and St Thomas’, says: “The success of the transplants owes a great deal to the fantastic team effort by staff from a variety of clinical backgrounds. The transplants required a huge amount of preparation and after-care, as well as the surgical procedures.
“We’re all immensely pleased that these pioneering kidney transplants have gone well and we’re now excited about being able to offer this service to other people with HIV in similar situations.”