Kidney-pancreas transplantation in a long-term non-progressor HIV-infected recipient.
With the introduction of highly active antiretroviral therapy (HAART), HIV infection has become a chronic disease with more frequent end-stage organ failures. As a result, the question of transplantation in HIV patients is raised more often. Although still subject to controversies, HIV infection is no longer an absolute contraindication to solid organ transplantation. We report a case of combined kidney-pancreas transplantation in a HIV recipient. HIV has remained stable without any antiviral therapy for up to 2 years after transplantation and has reached criteria for inclusion in the long-term nonprogressor (LTNP) group. Grafted organs demonstrated good function without rejection. This case emphasizes the need to consider LTNP HIV patients as a specific subgroup, when discussing solid organ transplantation. HAART is not required, thus sparing drug interactions and their unique immunological features, such as CCR5 mutation, might prevent rejection. This subgroup of HIV patients should be offered less restricted access to transplantation.
Toso
Christian
C
Transplantation Unit, Visceral and Transplant Surgery, University Hospitals, Geneva, Switzerland. christian.toso@hcuge.ch
Berney
Thierry
T
Oberholzer
José
J
Chave
Jean-Philippe
JP
Martin
Pierre-Yves
PY
Zeender
Eve
E
Bosco
Domenico
D
Morel
Philippe
P
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000150:complications; D006679:HIV Seropositivity; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D016035:Pancreas Transplantation / Q000379:methods*; D010182:Pancreatic Diseases / Q000209:etiology; D019713:Receptors, CCR5 / Q000235:genetics; D051437:Renal Insufficiency / Q000209:etiology; D013997:Time Factors
D019713:Receptors, CCR5