Current Transplantation Reports

, Volume 6, Issue 2, pp 167–176 | Cite as

Living Kidney Donation in Individuals with Hepatitis C and HIV Infection: Rationale and Emerging Evidence

  • Luckmini Liyanage
  • Abimereki D. Muzaale
  • Macey L. Henderson
  • Christine M. DurandEmail author
Live Kidney Donation (K Lentine and R Schaffer, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Live Kidney Donation


Purpose of Review

HIV-infected (HIV+) and hepatitis C virus-infected (HCV+) individuals with end-stage renal disease (ESRD) have decreased access to kidney transplantation. With new opportunities provided by the HIV Organ Policy Equity (HOPE) Act and direct-acting antivirals (DAAs) for HCV, we explore the potential risks and benefits of living-donor kidney transplantation from HIV+ or HCV+ donors from the perspective of both donor health and recipient outcomes.

Recent Findings

The HOPE Act permits organ donation from both deceased and living HIV+ persons to HIV+ recipients; however, there is only a clinical experience with HIV+ deceased donors to date. Empirical evidence demonstrates a low but acceptable risk of ESRD in potential HIV+ living donors without comorbidities who have well-controlled infection in the absence of donation. With the availability of potent DAAs for eradication of HCV infection, growing evidence shows good outcomes with HCV-seropositive and/or -viremic deceased kidney donors providing rationale to consider HCV+ living donors.


HIV+ and HCV+ living-donor kidney transplantations may improve access to transplant for vulnerable ESRD populations. Careful evaluation and monitoring are warranted to mitigate potential risks to donors and recipients.


HIV Hepatitis C Living donor Living-donor transplantation HIV Organ Policy Equity Act Direct-acting antivirals 



This work was supported in part from the National Cancer Institute (Durand, K23CA177321-01A1) and National Institute of Diabetes and Digestive and Kidney Diseases (Segev, K24DK101828 and R01AI120938) and the JHU Center for AIDS Research 1P30AI094189.

Compliance with Ethical Standards

Conflict of Interest

Macey Henderson is a member of the OPTN/UNOS board of directors.

Luckmini Liyanage, Abimereki D. Muzaale, and Christine M. Durand declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Luckmini Liyanage
    • 1
  • Abimereki D. Muzaale
    • 2
  • Macey L. Henderson
    • 2
  • Christine M. Durand
    • 1
    • 3
    Email author
  1. 1.Department of Medicine and OncologyJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of SurgeryJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Sidney Kimmel Cancer CenterJohns Hopkins University School of MedicineBaltimoreUSA

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