Harper University Hospital's Organ Transplant Program has performed kidney transplants in two patients with end-stage renal disease who were previously infected with the HIV virus but doing very well on highly active antiretroviral drug therapy. Both patients left the hospital with normal kidney function, and have continued to do exceedingly well following the surgery, with no episodes of transplant rejection or development of any kind of infection. These are the first two HIV-positive patients in the state of Michigan to receive kidney transplants. "The success of these cases is a tribute to the multidisciplinary team of experts in transplant surgery, transplant nephrology, transplant infectious disease, and transplant pharmacy that we have established here at Harper University Hospital and Wayne State University to care for these very complex patients", says Scott A. Gruber, M.D., Ph.D., FACS, FCP, Director of Harper University Hospital's Organ Transplant Program and Professor and Chief, Section of Transplant Surgery, Wayne State University. "Management of these patients following transplantation involves a delicate balance between dosing the immunosuppressive drugs needed to prevent organ rejection and the highly active antiretroviral drugs used to control HIV infection, since these two classes of medications may interact with each other. Establishment of a multidisciplinary team has permitted us to remain on the cutting edge with regard to all new developments in kidney transplantation."

Until recently, HIV-infected patients were excluded from consideration for solid-organ transplantation. However, in response to the marked reductions in morbidity and mortality associated with HIV infection due to the effective use of highly active antiretroviral therapy, multiple transplant centers around the country have revised their clinical criteria according to an established National Institutes of Health protocol to allow kidney transplantation in this group of patients. Preliminary results have been gratifying, suggesting that short-term patient and graft survival in appropriately-chosen HIV-positive kidney transplant candidates are equivalent to those in non-HIV infected patients.