Outcome after orthotopic liver transplantation in five HIV-infected patients with virus hepatitis-induced cirrhosis.
BACKGROUND
We report on our experiences with orthotopic liver transplantation (OLT) in HIV-infected patients. Between July 1998 and October 2001, five HIV-infected patients underwent OLT because of virus-induced liver cirrhosis. One patient suffered from hepatitis B virus (HBV)-, three patients from hepatitis C virus (HCV)- and one patient from HCV/HBV/HDV-related cirrhosis (HDV, hepatitis D virus). The mean duration of HIV infection was 15 years. Patients were prospectively followed up with a mean duration of 25.6 months.


RESULTS
Three patients died 3, 10 and 31 months after OLT, respectively, due to graft failure. The causes of graft failure were: recurrent thrombosis of the hepatic artery, HCV-associated cholestatic hepatitis and chemotherapy-induced liver damage due to Hodgkin's disease, which was diagnosed 17 months after OLT, in addition to chronic HCV disease. The two survivors show a stable liver function and non-progredient HIV infection under antiretroviral therapy 61 and 23 months after OLT, respectively.


CONCLUSIONS
A medium- or even long-term survival after OLT can be achieved in HIV-infected patients without progression of HIV disease under antiretroviral therapy. However, in our study three out of five patients died due to graft failure. Therefore, prognostic criteria have to be defined for the selection of HIV-infected patients, who may benefit from OLT.
Radecke
Klaus
K
Department of Gastroenterology and Hepatology, University Hospital Essen, 45147 Essen, Germany.
Frühauf
Nils R
NR
Miller
Michael
M
Ross
Birgit
B
Köditz
Roland
R
Malagó
Massimo
M
Broelsch
Christoph E
CE
Gerken
Guido
G
Treichel
Ulrich
U
D000328:Adult; D005260:Female; D006084:Graft Rejection / Q000209:etiology / Q000401:mortality / Q000473:pathology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006525:Hepatitis, Viral, Human; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000401:mortality / Q000601:surgery* / Q000821:virology; D017114:Liver Failure, Acute / Q000401:mortality / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D015996:Survival Rate
D007166:Immunosuppressive Agents