title: Renal Transplantation in HIV-Infected Patients: The First Portuguese Review.
abstract: BACKGROUND
  With the introduction of combination antiretroviral therapy (cART), prognosis of human immunodeficiency virus (HIV) infection has been improved and kidney transplantation (KT) in HIV-positive patients became possible.
  
  
  METHODS
  We reviewed the demographic, clinical, laboratory, and therapeutic data of all the HIV-infected patients who underwent KT between 2009 (first KT in Portugal in a HIV-infected patient) and May 2014. Case accrual was through all Portuguese KT centers where a KT in an HIV-infected patient was performed. Patients were transplanted following the American and Spanish guideline recommendations that included maintenance on cART, undetectable plasma HIV RNA copies, and absolute CD4 counts of ≥ 200 cells/μL in the last 6 months.
  
  
  RESULTS
  Fourteen KT were performed on men and 3 on women. The mean age of patients at the time of transplantation was 49.9 ± 11.7 years. HIV status was known for 12 ± 5 years. Eight patients had AIDS in the past and all patients received grafts from deceased donors. Twelve patients (64.7%) underwent induction therapy with basiliximab and 2 patients experienced early graft loss. In 2 patients, humoral rejection was diagnosed and in 3 patients, cellular rejection. Two patients died and an additional patient had early graft loss.
  
  
  CONCLUSIONS
  KT is a possible, but challenging, renal replacement therapy in selected HIV-positive patients. Even in those with AIDS criteria in the past, when the disease is controlled, and after the reconstitution of the immune system with cART, KT can be performed. Nevertheless, the risk-benefit ratio for each patient needs to be taken in consideration.
authors.affiliation: Nephrology, Centro Hospitalar do Médio Tejo, Torres Novas, Portugal. Electronic address: saraqueridoconde@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Querido
authors.affiliation: Nephrology, Centro Hospitalar de Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: D
authors.initials: D
authors.lastname: Machado
authors.affiliation: Nephrology, Centro Hospitalar de Lisboa Central, Hospital Curry Cabral, Lisboa, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Silva
authors.affiliation: Nephrology, Centro Hospitalar de Lisboa Central, Hospital Curry Cabral, Lisboa, Portugal.
authors.forename: F
authors.initials: F
authors.lastname: Nolasco
authors.affiliation: Nephrology, Hospital de São João, Porto, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Nunes
authors.affiliation: Nephrology, Hospital de São João, Porto, Portugal.
authors.forename: S
authors.initials: S
authors.lastname: Sampaio
authors.affiliation: Nephrology, Hospital Garcia de Orta, Almada, Portugal.
authors.forename: P
authors.initials: P
authors.lastname: Cruz
authors.affiliation: Nephrology, Hospital Garcia de Orta, Almada, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Oliveira
authors.affiliation: Nephrology, Centro Hospitalar de Lisboa Ocidental, Hospital de Santa Cruz, Carnaxide, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Weigert
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D000077552:Basiliximab; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006679:HIV Seropositivity; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011174:Portugal; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab