HIV-infected liver and kidney transplant recipients: 1- and 3-year outcomes

M. E. Roland, B. Barin, L. Carlson, L. A. Frassetto, N. A. Terrault, R. Hirose, C. E. Freise, L. Z. Benet, N. L. Ascher, J. P. Roberts, B. Murphy, M. J. Keller, K. M. Olthoff, E. A. Blumberg, K. L. Brayman, S. T. Bartlett, C. E. Davis, J. M. McCune, B. M. Bredt, D. M. StableinP. G. Stock

Research output: Contribution to journalArticle

184 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)355-365
Number of pages11
JournalAmerican Journal of Transplantation
Volume8
Issue number2
DOIs
StatePublished - Feb 2008
Externally publishedYes

Keywords

  • End-stage liver disease
  • End-stage renal disease
  • HIV
  • Hepatitis B virus (HBV)
  • Hepatitis C virus
  • Transplantation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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    Roland, M. E., Barin, B., Carlson, L., Frassetto, L. A., Terrault, N. A., Hirose, R., Freise, C. E., Benet, L. Z., Ascher, N. L., Roberts, J. P., Murphy, B., Keller, M. J., Olthoff, K. M., Blumberg, E. A., Brayman, K. L., Bartlett, S. T., Davis, C. E., McCune, J. M., Bredt, B. M., ... Stock, P. G. (2008). HIV-infected liver and kidney transplant recipients: 1- and 3-year outcomes. American Journal of Transplantation, 8(2), 355-365. https://doi.org/10.1111/j.1600-6143.2007.02061.x