Thanks to better medications and care, patients with HIV are living longer, healthier lives. The flip side is that many of these patients are developing end stage liver and kidney disease.

Despite many challenges, advances in medications and promising research have begun to nudge open doors that were previously closed to this patient population, according to an article by Laurie Carlson in the November-December 2008 issue of Nephrology Nursing Journal . In the past, for example, patients who were HIV positive were not considered possible transplant recipients as physicians felt the immunosuppressive medications used to prevent rejection would further compromise their already taxed systems and increase their risk for infection and death. Also, organs are always in great demand and go to patients who are expected to have a better outcome of survival.

Following strides in care and improved HIV drugs, the National Institutes of Health in 2000 launched a study to evaluate transplants in HIV-infected individuals.

“The preliminary results are encouraging enough to dispute the conventional wisdom that individuals infected with HIV should never be considered as potential transplant recipients,” Carlson writes. “As more transplant centers begin transplanting HIV-infected individuals following a standard protocol, more data will become available to address the many questions that await clarification.”

Protocols include strategies that improve outcomes such as pre-transplant screenings for vaccinations, infectious diseases, and tuberculosis. Post-transplant, medication management and prevention of opportunistic infections are also carefully monitored.

(Clinical Management of the HIV-Positive Kidney Transplant Recipient; Laurie Carlson, MSN, RN; Nephrology Nursing Journal; November-December 2008; annanurse/journal)

Nephrology Nursing Journal is a refereed clinical and scientific resource that provides current information on a wide variety of subjects to facilitate the practice of professional nephrology nursing. Its purpose is to disseminate information on the latest advances in research, practice, and education to nephrology nurses to positively influence the quality of care they provide.

Nephrology Nursing Journal