Renal transplantation in HIV-infected patients: the Paris experience.
Kidney transplantation is now considered as a reasonable option for HIV-infected patients with end-stage renal disease. We describe here a retrospective study conducted in five transplantation centers in Paris. Twenty-seven patients were included. Immunosuppressive protocol associated an induction therapy and a long-term treatment combining mycophenolate mofetil, steroids and either tacrolimus or cyclosporine. All the patients had protocol biopsies at 3 months and 1 year. Patient's survival was 100% at 1 year and 98% at 2 years. Graft survival at 1 and 2 years is 98% and 96% at 1 and 2 years, respectively. The mean glomerular filteration rate values at 12 and 24 months were 60.6 mL/min/1.73 m² (range 23-98) and 65.4 mL/min/1.73 m² (range 24-110), respectively. Acute cellular rejection was diagnosed in four cases (15%). Because of high trough levels of calcineurin inhibitor, protease-inhibitor therapies were withdrawn in 11 cases. HIV disease progression was not observed. One patient developed B-cell lymphoma. In conclusion, our study confirms the safety of renal transplantation in HIV-infected patients with few adverse events and a low incidence of acute rejection.
Touzot
M
M
Service de Néphrologie, Université Denis Diderot-Paris VII, Hôpital Saint Louis, Paris, France.
Pillebout
E
E
Matignon
M
M
Tricot
L
L
Viard
J P
JP
Rondeau
E
E
Legendre
C
C
Glotz
D
D
Delahousse
M
M
Lang
P
P
Peraldi
M N
MN
D000328:Adult; D016572:Cyclosporine / Q000008:administration & dosage; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D015658:HIV Infections / Q000150:complications* / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D012189:Retrospective Studies; D016559:Tacrolimus / Q000008:administration & dosage
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus