MUSC researcher addresses disparities in kidney transplant access for persons living with HIV

Kidney transplant access for persons living with HIV

Dr. Ruth AdekunlePersons living with HIV (PLWH) are at an increased risk of developing end-stage renal disease (ESRD) compared with the general population. Despite this, PLWH are less likely to make it to the kidney transplant waiting list. Researchers in the lab of Ruth Adekunle, M.D., are conducting a study to better understand how PLWH proceed through the transplant process at MUSC.

Dr. Adekunle along with her research assistant Kyle Crawford, determined that between May 1, 2012 and December 31, 2021, 45 patients have been referred for kidney transplant at MUSC, of which 22 (49%) made it to the organ waitlist and 13 (29%) were ultimately transplanted. Though these numbers seem small, they are higher than what has been reported from other facilities. The most common reason for not completing the transplant evaluation process was co-morbid psychiatric conditions and having a history of substance abuse. In a similar study conducted on the veteran population, Dr. Adekunle and team determined that veterans with HIV are 30% less likely to receive a kidney transplant and additionally spend a longer time on the waitlist compared to a non-HIV veteran population.

Dr. Adekunle's goal is to increase awareness of the disparities in access to kidney transplants for PLWH and develop ways to better support PLWH undergoing the transplant process, which would increase their chance of being eligible for kidney transplantation.

IMPACT of COVID-19 on Veterans with HIV

In 2020, public health efforts to curb the spread of COVID-19 required structural changes to health care delivery. Unintended consequences of these shifts in access to medical care may have further exacerbated racial, geographical, and social disparities that existed long before COVID-19 among marginalized populations such as PLWH. Dr. Adekunle’s project aims to better understand the short and long-term impact of COVID-19 on care retention among veterans with HIV and identify the barriers that prevented engagement and retention in care. This project is still in the data gathering stage, but Dr. Adekunle hopes to learn how to optimize HIV care delivery that is sensitive to socioeconomic vulnerabilities.