Liver retransplantation in HIV-infected patients: A prospective cohort study

M. Gastaca, F. Aguero, A. Rimola, M. Montejo, P. Miralles, R. Lozano, L. Castells, M. Abradelo, M. De La Mata, F. San Juan Rodríguez, E. Cordero, S. Del Campo, C. Manzardo, J. O. De Urbina, I. Pérez, G. De La Rosa, J. M. Miro

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9 Citations (Scopus)

Abstract

Information regarding liver retransplantation in HIV-infected patients is scant. Data from 14 HIV-infected patients retransplanted between 2002 and 2011 in Spain (6% retransplantation rate) were analyzed and compared with those from 157 matched HIV-negative retransplanted patients. In HIV-infected patients, early (≤30 days) retransplantation was more frequently indicated (57% vs. 29%; p = 0.057), and retransplantation for HCV recurrence was less frequently indicated (7% vs. 37%; p = 0.036). Survival probability after retransplantation in HIV-positive patients was lower than in HIV-negative patients, 42% versus 64% at 3 years, although not significantly (p = 0.160). Among HIV-infected patients, those with undetectable HCV RNA at retransplantation and those with late (>30 days) retransplantation showed better 3-year survival probability (80% and 67%, respectively), similar to that in their respective HIV-negative counterparts (72% and 70%). In HIV-infected and HIV-negative patients, 3-year survival probability in those with positive HCV RNA at retransplantation was 22% versus 65% (p = 0.008); in those with early retransplantation, 3-year survival probability was 25% versus 56% (p = 0.282). HIV infection was controlled with antiretroviral therapy after retransplantation. In conclusion, HIV-infected patients taken as a whole have unsatisfactory survival after liver retransplantation, although patients with undetectable HCV RNA at retransplantation or undergoing late retransplantation show a more favorable outcome. HIV-infected liver transplant patients have lower survival after liver retransplantation than matched HIV-negative liver retransplanted recipients; however, HIV-infected patients with undetectable HCV RNA at retransplantation or undergoing late retransplantation have a more favorable outcome, similar to that in their HIV-negative counterparts. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.
Original languageEnglish
Pages (from-to)2465-2476
JournalAmerican Journal of Transplantation
Volume12
Issue number9
DOIs
Publication statusPublished - 1 Sep 2012

Keywords

  • Chronic rejection
  • HBV infection
  • HCV infection
  • HCV recurrence
  • HIV infection
  • liver retransplantation
  • primary-graft nonfunction
  • Spain
  • survival
  • vascular thrombosis

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