Solid organ transplantation in people with HIV: Outcomes, obstacles and opportunities

People with HIV experience disparate access to solid organ transplantation (SOT), despite mounting evidence for comparable outcomes. This review aims to understand the outcomes following SOT, obstacles to SOT and opportunities to improve access and outcomes following SOT.

We conducted a narrative review of the literature.

SOT is safe and effective for people with HIV, and increasing evidence indicates that people with HIV may safely donate organs to others with HIV. People with HIV experience a higher risk of acute rejection following SOT, without a higher risk of graft loss or death, when compared with appropriately matched controls. Those with HIV experience systemic and structural barriers to SOT, in addition to barriers that occur at the level of healthcare providers and consumers. Opportunities exist to improve access to SOT, and to improve SOT-related care for people with HIV.

SOT should be considered standard of care for people with HIV when indicated. Further efforts are required to identify and address gaps in the SOT-related cascade of care; and to improve SOT outcomes for people with HIV.