Center-Level Experience and Kidney Transplant Outcomes in HIV-Infected Recipients

J. E. Locke, R. D. Reed, S. G. Mehta, C. Durand, R. B. Mannon, P. Maclennan, B. Shelton, M. Y. Martin, H. Qu, R. Shewchuk, D. L. Segev

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Excellent outcomes among HIV+ kidney transplant (KT) recipients have been reported by the NIH consortium, but it is unclear if experience with HIV+ KT is required to achieve these outcomes. We studied associations between experience measures and outcomes in 499 HIV+ recipients (SRTR data 2004-2011). Experience measures examined included: (1) center-level participation in the NIH consortium; (2) KT experiential learning curve; and (3) transplant era (2004-2007 vs. 2008-2011). There was no difference in outcomes among centers early in their experience (first 5 HIV+ KT) compared to centers having performed >6 HIV+ KT (GS adjusted hazard ratio [aHR]: 1.05, 95% CI: 0.68-1.61, p = 0.82; PS aHR: 0.93; 95% CI: 0.56-1.53, p = 0.76), and participation in the NIH-study was not associated with any better outcomes (GS aHR: 1.08, 95% CI: 0.71-1.65, p = 0.71; PS aHR: 1.13; 95% CI: 0.68-1.89, p = 0.63). Transplant era was strongly associated with outcomes; HIV+ KTs performed in 2008-2011 had 38% lower risk of graft loss (aHR: 0.62; 95% CI: 0.42-0.92, p = 0.02) and 41% lower risk of death (aHR: 0.59; 95% CI: 0.39-0.90, p = 0.01) than that in 2004-2007. Outcomes after HIV+ KT have improved over time, but center-level experience or consortium participation is not necessary to achieve excellent outcomes, supporting continued expansion of HIV+ KT in the US.

Original languageEnglish (US)
Pages (from-to)2096-2104
Number of pages9
JournalAmerican Journal of Transplantation
Issue number8
StatePublished - Aug 1 2015
Externally publishedYes


  • (SRTR)
  • Scientific Registry for Transplant Recipients
  • clinical research/practice
  • graft survival
  • health services and outcomes research
  • infection and infectious agents
  • infectious disease
  • kidney (allograft) function/dysfunction
  • kidney transplantation/nephrology
  • patient survival
  • viral: human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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