In a world first, surgeons in the US have performed a kidney transplant from a living donor with HIV. Not only is this a breakthrough for biomedical science, but it’s also an incredible opportunity to break down many of the old stigmas and misconceptions associated with HIV.
Nina Martinez, a 35-year-old living with HIV, donated her kidney to an HIV-positive stranger in an operation that took place at the Johns Hopkins Hospital on Monday, March 25. The operation appears to be a complete success so far. In fact, Nina is even planning on taking part in the US Marine Corps Marathon later this year.
“I’m feeling good,” Nina said at a press conference on Thursday.
“I want people to change what they believe they know about HIV. I don’t want to be anyone’s hero. I want to be someone’s example, someone’s reason to consider donating,” she added.
The anonymous recipient is also expected to be released from the hospital in the next few days.
Dorry Segev, professor of surgery at the Johns Hopkins School of Medicine, explained that two big hurdles stopped this breakthrough from happening sooner.
Until recently, federal law did not allow donation of organs for people living with HIV. However, scientists started to consider that people with HIV can now live long and healthy lives, and many of them would make great donors for other people with HIV. In 2013, the HIV Organ Policy Equity Act (HOPE Act) was passed, changing the rules for organ donation between HIV-positive individuals.
On top of this, there were also medical hurdles to overcome. Researchers were unsure whether a person with HIV could live with just one kidney, especially considering HIV is historically associated with kidney disease. Antiretroviral therapy for HIV patients can also put an extra strain on the kidney. However, the transplant team carried out a study of over 40,000 people with HIV and found that the risk of kidney disease was relatively minimal in the age of modern treatment.
Following the first deceased donor transplant in 2016, also carried out at Johns Hopkins, this new project got the go-ahead.
"A disease that was a death sentence in the 1980s has become one so well-controlled that those living with HIV can now save lives with kidney donation – that's incredible," Segev said in a statement.
Nina’s involvement with the breakthrough came in July 2018 when she read on Facebook that a friend, who also happened to have HIV, needed a kidney transplant. This led her to contact Johns Hopkins Hospital, which was also becoming interested in the idea of HIV-to-HIV living donor kidney transplants. Although her friend, unfortunately, passed away before they could receive a kidney, Nina’s incredible bravery has now helped another person in need.
"Despite losing my friend to kidney disease, I wanted to move forward with donation as a way to honor them," she said. "I could do this for someone else, not because I'm special but because I'm strong. Other people living with HIV before me participated in clinical research so that I could not just survive but thrive.
“It was my turn to do this, for both my friend that I cared about and all people waiting on a transplant."