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Liver transplantation in HIV-infected recipients
- Source :
- Liver Transplantation. 11:76-81
- Publication Year :
- 2004
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2004.
-
Abstract
- Liver transplantation is being evaluated as a therapeutic option for human immunodeficiency virus (HIV)-infected patients with end-stage liver disease, but experience is still scarce. We describe the outcome of 4 HIV-infected patients who underwent liver transplantation in our hospital between July 2002 and April 2003. HIV-infected liver transplant recipients meet the same standard criteria for transplantation as do HIV-negative candidates. In addition, HIV infected persons are required to have a CD4 T-cell count greater than 100/mL (CD4 T-cells are targets for HIV infection). Immunosuppressive regimens, perioperative surgical prophylaxis, and prophylaxis for opportunistic infections are standard in the Liver Transplantation Unit in our hospital. Four patients, including 3 former intravenous drug users, received a liver transplant (2 from deceased donors and 2 from living donors), with a median follow-up of 510 days. Three patients (75%) are alive, with 1 death occurring 17 months posttransplantation in a patient who developed fibrosing cholestatic hepatitis. Rejection occurred in 1 patient, and was managed with no complications. Hepatitis C virus (HCV) recurrence occurred in 3 patients. HIV-infection has remained under control with antiretroviral treatment. A combination of 3 nucleoside analogs was used in 3 patients, with no need for drug adjustments. No opportunistic infections or other significant infectious complications developed. In conclusion, orthotopic liver transplantation seems a safe therapeutic option in the short term for HIV-infected persons with end stage liver disease, including patients with a history of drug abuse. If indicated, an antiretroviral regimen consisting of 3 nucleosides could be used to avoid interactions with immunosuppressive drugs. (Liver Transpl 2005;11:76–81.)
- Subjects :
- Transplantation
medicine.medical_specialty
Hepatology
Nucleoside analogue
business.industry
medicine.medical_treatment
Hepatitis C virus
Perioperative
Liver transplantation
medicine.disease
medicine.disease_cause
Surgery
Liver disease
Surgical prophylaxis
Regimen
Internal medicine
medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 15276465
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Liver Transplantation
- Accession number :
- edsair.doi...........bbb85f98e597b457dc0420e65a6bf75e