title: HIV-infected liver and kidney transplant recipients: 1- and 3-year outcomes.
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.
authors: University of California, San Francisco, CA, USA. Michelle.Roland@cDpH.CA.gov
authors: M E
authors: ME
authors: Roland
authors: B
authors: B
authors: Barin
authors: L
authors: L
authors: Carlson
authors: L A
authors: LA
authors: Frassetto
authors: N A
authors: NA
authors: Terrault
authors: R
authors: R
authors: Hirose
authors: C E
authors: CE
authors: Freise
authors: L Z
authors: LZ
authors: Benet
authors: N L
authors: NL
authors: Ascher
authors: J P
authors: JP
authors: Roberts
authors: B
authors: B
authors: Murphy
authors: M J
authors: MJ
authors: Keller
authors: K M
authors: KM
authors: Olthoff
authors: E A
authors: EA
authors: Blumberg
authors: K L
authors: KL
authors: Brayman
authors: S T
authors: ST
authors: Bartlett
authors: C E
authors: CE
authors: Davis
authors: J M
authors: JM
authors: McCune
authors: B M
authors: BM
authors: Bredt
authors: D M
authors: DM
authors: Stablein
authors: P G
authors: PG
authors: Stock
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002102:Cadaver; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology / Q000706:statistics & numerical data*; D016031:Liver Transplantation / Q000276:immunology / Q000706:statistics & numerical data*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D016896:Treatment Outcome; D019562:Viral Load