Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Transplant. Sep 18, 2026; 16(3): 120869
Published online Sep 18, 2026. doi: 10.5500/wjt.120869
Published online Sep 18, 2026. doi: 10.5500/wjt.120869
Hope for kidney transplantation in candidates with human immunodeficiency virus
Amer Ashaab Belal, Issa Haddad, Alfonso H Santos Jr, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida College of Medicine, Gainesville, FL 32610, United States
Rafael Aldaya Bourricaudy, Zahra Saba, Saba Ali, College of Medicine, University of Florida, Gainesville, FL 32610, United States
Author contributions: Belal AA contributed to leading the original draft; Belal AA, Bourricaudy RA, Saba Z, and Ali S contributed to the writing; Belal AA, Bourricaudy RA, Saba Z, and Ali S contributed to the literature review; Belal AA, Bourricaudy RA, Saba Z, and Ali S; Haddad I and Santos Jr AH contributed to the revision the manuscript; Belal AA and Santos Jr AH contributed to the conception; and all the authors approved of the final version of the manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Amer A Belal, MD, FASN, Clinical Assistant Professor, Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida College of Medicine, 1600 SW Archer Road, P.O. Box 100224, Gainesville, FL 32610, United States. amer.belal@medicine.ufl.edu
Received: March 11, 2026
Revised: April 20, 2026
Accepted: May 7, 2026
Published online: September 18, 2026
Processing time: 173 Days and 7.5 Hours
Revised: April 20, 2026
Accepted: May 7, 2026
Published online: September 18, 2026
Processing time: 173 Days and 7.5 Hours
Core Tip
Core Tip: Patients living with both end-stage kidney disease (ESKD) and human immunodeficiency virus (HIV) have faced barriers accessing the kidney transplant waiting list. The HIV Organ Policy Equity (HOPE) act in 2013 and the HOPE act variance in 2015 restricted HIV positive donor (+D) to HIV positive recipient (+R) transplants to research protocols. Federal regulatory changes in 2024-2025 removed the above research restrictions for transplant centers. The evidence supports kidney transplantation as the standard of care for patients living with both ESKD and HIV, and that HIV +D to HIV +R transplantation is non-inferior to the use of donors without HIV for candidates living with HIV.