HIV-Infected Liver and Kidney Transplant Recipients: 1- and 3-Year Outcomes

[Guest guest]

American Journal of Transplantation 8 (2), 355–365.

doi:10.1111/j.1600-6143.2007.02061.x

Abstract

HIV-Infected Liver and Kidney Transplant Recipients: 1- and 3-Year Outcomes

M. E. Rolanda,*aUniversity of California, San Francisco, CA*Corresponding

author: E. Roland, .Roland@..., B. BarinbbEMMES

Corporation, Rockville, MD, L. CarlsonaaUniversity of California, San Francisco,

CA, L. A. FrassettoaaUniversity of California, San Francisco, CA, N. A.

TerraultaaUniversity of California, San Francisco, CA, R. HiroseaaUniversity of

California, San Francisco, CA, C. E. FreiseaaUniversity of California, San

Francisco, CA, L. Z. BenetaaUniversity of California, San Francisco, CA, N. L.

AscheraaUniversity of California, San Francisco, CA, J. P. aaUniversity

of California, San Francisco, CA, B. ccMount Sinai School of Medicine, New

York, NY, M. J. KellerccMount Sinai School of Medicine, New York, NY, K. M.

OlthoffddUniversity of Pennsylvania, Philadelphia, PA, E. A.

BlumbergddUniversity of Pennsylvania, Philadelphia, PA, K. L.

BraymaneeUniversity of Virginia, Charlottesville, VA, S. T. BartlettffUniversity

of land, Baltimore, MD, C. E. ffUniversity of land, Baltimore, MD,

J. M. McCuneaaUniversity of California, San Francisco, CA, B. M.

BredtaaUniversity of California, San Francisco, CA, D. M. StableinbbEMMES

Corporation, Rockville, MD and P. G. StockaaUniversity of California, San

Francisco, CAaUniversity of California, San Francisco, CA bEMMES Corporation,

Rockville, MD cMount Sinai School of Medicine, New York, NY dUniversity of

Pennsylvania, Philadelphia, PA eUniversity of Virginia, Charlottesville, VA

fUniversity of land, Baltimore, MD

*Corresponding author: E. Roland, .Roland@...

Abstract

Improvements in human immunodeficiency virus (HIV)-associated mortality make it

difficult to deny transplantation based upon futility. Outcomes in the current

management era are unknown. This is a prospective series of liver or kidney

transplant recipients with stable HIV disease. Eleven liver and 18 kidney

transplant recipients were followed for a median of 3.4 years (IQR

[interquartile range] 2.9–4.9). One- and 3-year liver recipients’ survival was

91% and 64%, respectively; kidney recipients’ survival was 94%. One- and 3-year

liver graft survival was 82% and 64%, respectively; kidney graft survival was

83%. Kidney patient and graft survival were similar to the general transplant

population, while liver survival was similar to the older population, based on

1999–2004 transplants in the national database. CD4+ T-cell counts and HIV RNA

levels were stable; and there were two opportunistic infections (OI). The 1- and

3-year cumulative incidence (95% confidence intervals [CI]) of rejection

episodes for kidney recipients was 52% (28–75%) and 70% (48–92%), respectively.

Two-thirds of hepatitis C virus (HCV)-infected patients, but no patient with

hepatitis B virus (HBV) infection, recurred. Good transplant and HIV-related

outcomes among kidney transplant recipients, and reasonable outcomes among liver

recipients suggest that transplantation is an option for selected HIV-infected

patients cared for at centers with adequate expertise

_________________________________________________________________

Share life as it happens with the new Windows Live.

http://www.windowslive.com/share.html?ocid=TXT_TAGHM_Wave2_sharelife_012008