[The Argentine experience with human immune deficiency virus positive patients in the waiting list for liver transplantation: preliminary analysis].
After the introduction of high active antiretroviral therapy (HAART), the human immunodeficiency virus (HIV) was no longer considered a contraindication for transplantation. Yet, liver disease in this population is characterized by an accelerated course that may impact on the waiting list.


OBJECTIVE
To evaluate the experience in Argentina with HIV positive patients listed for liver transplantation.


METHODS
We analyzed 52 HIV positive patients listed between July 2005 and March 2010 (Group HIV positive). Results were compared with 462 HIV negative patients included during the same period (Group HIV negative). Data were obtained from INCUCAI, the Argentinian procurement organism and from the Transplantation Centers.


RESULTS
The etiology of liver disease in the Group HIV positive was hepatitis C 40, HBV 3, fulminant hepatitis 3, alcohol 2, retrasplant 2 and others 2. The mean MELD at the time of listing was 1615 (lower than 19 in 40 cases, higher than 19 in 8, emergency in 3) in the group HIV positive and 16.64 in the group HIV negative (NS). The outcome in the waiting list for HIV positive and negative patients respectively was: death 14 (27%) vs 61 (18.7%) (P < 0.05), cadaveric donor transplant 10 (13%) vs 95 (29.4%) (P < 0.001), living donor transplant 0 (0%) vs 5 (1.1%) (NS), mean time from listing to death 270.70 298.11 days vs 267.29 266.53 days (NS), mean time from listing to transplant 70.26 74.05 vs 261 187.6 days (P < 0.01), mean MELD at the time of death 12.54 (13 cases lower than 15, 1 higher than 19) vs 19.6 9.7 (P < 0.05), mean MELD at the time of transplantation 24.33 vs 24.1 7.6 (NS).


CONCLUSIONS
HIV positive patients have high mortality in the waiting list and low access to liver transplantation. MELD score underscores the severity of liver disease in this population when compared to HIV negative patients.
Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina. alejandra.villamil@hospitalitaliano.org.ar
Alejandra
A
Villamil
Liliana
L
Bisignano
Federico
F
Orozco
Juan Carlos
JC
Bandi
Laura
L
Barcán
Lucas
L
McCormack
Gabriel
G
Gondolesi
Eduardo de
Ed
Santibañes
Adrián
A
Gadano
D000293:Adolescent; D000328:Adult; D000368:Aged; D001118:Argentina; D005260:Female; D006679:HIV Seropositivity / Q000821:virology*; D006801:Humans; D017093:Liver Failure / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D014850:Waiting Lists; D055815:Young Adult