Solid Organ Transplants in HIV-Infected Patients

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A prospective, multicenter US cohort study comparing patient and graft survival for 89 HCV/HIV-co-infected patients and 2 control groups: 235 HCV-monoinfected liver transplant controls and all US transplant recipients who were 65 years old or older. Patient and graft survival rates were lower for HCV/HIV-co-infected liver transplant patients compared to HCV-monoinfected liver transplant patients, and rates of treated acute rejection (but not the rates of HCV disease severity) were significantly higher for HCV/HIV-co-infected recipients versus HCV-infected recipients. The authors concluded that HCV per se is not a contraindication to liver transplant in HIV-infected patients, but recipient and donor selection and the management of acute rejection strongly influence outcomes. Harbell J, Fung J, Nissen N, et al. Surgical complications in 275 HIV-infected liver and/or kidney transplantation recipients. Surgery. 2012;152:376–81. •• Stock PG, Barin B, Murphy B, et al. 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Liver Transpl. 2003;9:239–47. Prachalias AA, Pozniak A, Taylor C, et al. Liver transplantation in adults co-infected with HIV. Transplantation. 2001;72:1684–8. Ragni MV, Belle SH, Im K, et al. Survival of human immunodeficiency virus-infected liver transplant recipients. J Infect Dis. 2003;188:1412–20. • Cooper C, Kanters S, Klein M, et al. Liver transplant outcomes in HIV-infected patients: a systematic review and meta-analysis with synthetic cohort. AIDS. 2011;25:777–86. A meta-analysis to evaluate the effectiveness of liver transplantation in HIV-hepatitis co-infected patients. Within the HIV-infected population evaluated, HIV-hepatitis B virus (HBV) co-infection was associated with optimal survival. Individuals with an undetectable HIV viral load at the time of transplantation were more likely to survive when compared to those with detectable HIV viremia. Terrault NA, Carter JT, Carlson L, et al. 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