[GESIDA/GESITRA-SEIMC, PNS and ONT consensus document on solid organ transplant (SOT) in HIV-infected patients in Spain (March, 2005)].
Solid organ transplant may be the only therapeutic alternative in some HIV-infected patients. Experience in North America and Europe during the last five years shows that survival at three years after an organ transplant is similar to that observed in HIV-negative patients. The criteria agreed upon to select HIV patients for transplant are: no opportunistic infections (except tuberculosis, oesophageal candidiasis or P. jiroveci -previously carinii- pneumonia), CD4 lymphocyte count above 200 cells/.L (100 cells/.L in the case of liver transplant) and an HIV viral load which is undetectable or suppressible with antiretroviral therapy. Another criterion is a two-year abstinence from heroin and cocaine, although the patient may be in a methadone programme. The main problems in the post-transplant period are pharmacokinetic and pharmacodynamic interactions between antiretorivirals and immunosuppressors, rejection and the management of relapse of HCV infection, which is one of the main causes of post-liver transplant mortality. Up to now, experience with pegylated interferon and ribavirin is scarce in this population. The English version of the manuscript is available at http://www.gesidaseimc.com.
Miró
José M
JM
AIDS Study Group (GESIDA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC). jmmiro@ub.edu
Torre-Cisnero
Julián
J
Moreno
Asunción
A
Tuset
Montserrat
M
Quereda
Carmen
C
Laguno
Montserrat
M
Vidal
Elisa
E
Rivero
Antonio
A
Gonzalez
Juan
J
Lumbreras
Carlos
C
Iribarren
José A
JA
Fortún
Jesús
J
Rimola
Antonio
A
Rafecas
Antonio
A
Barril
Guillermina
G
Crespo
Marisa
M
Colom
Joan
J
Vilardell
Jordi
J
Salvador
José A
JA
Polo
Rosa
R
Garrido
Gregorio
G
Chamorro
Lourdes
L
Miranda
Blanca
B
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000517:prevention & control; D019380:Anti-HIV Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D000998:Antiviral Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D019090:Case Management; D015897:Comorbidity; D000075202:Contraindications; D018450:Disease Progression; D004347:Drug Interactions; D006084:Graft Rejection; D015658:HIV Infections / Q000453:epidemiology*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D006525:Hepatitis, Viral, Human / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D016377:Organ Transplantation / Q000941:ethics / Q000592:standards*; D010349:Patient Compliance; D018579:Patient Selection; D012008:Recurrence; D013030:Spain / Q000453:epidemiology
D019380:Anti-HIV Agents; D000998:Antiviral Agents; D007166:Immunosuppressive Agents