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Abstract
HIV-infected liver and kidney transplant recipients: 1- and 3-year outcomes
M. Roland1, B. Barin2, L. Carlson3, L. Frassetto3, N. Terrault3, R. Hirose3, C. Freise3, L. Benet3, N. Ascher3, J. Roberts3, B. Murphy4, M. Keller4, K. Olthoff5, E. Blumberg5, K. Brayman6, S. Bartlett7, C. Davis7, J. McCune3, B. Bredt3, D. Stablein2, P. Stock3
Background: Longer term survival, HIV progression, rejection rates and organ function in HIV-infected transplant recipients are unknown.
Subjects:
1) CD4 count - kidney > 200; liver > 100;
2) opportunistic complications excluded until 4/02, then continued exclusion of PML, cryptosporidiosis and visceral KS.
Statistical analyses:
1) Kaplan-Meier - patient & graft survival, rejection;
2) Generalized linear regression - predictors of CD4+ T cell changes;
3) Cox regression - predictors of rejection and
4) Wilcoxon signed rank - changes in creatinine.
Results: 29 subjects followed for 2-5 years through 11/17/05.
Table 1.
Patient and Graft Survival in HIV-Infected Subjects and Organ Procurement and Transplantation Network Database
| | One Year Patient Survival | Three Year Patient Survival | | | Liver | Kidney | Liver | Kidney | | Subjects | 90.9
(73.9, 100)
| 93.8
(81.9, 100)
| 71.6
(44.2, 99.0)
| 93.8
(81.9, 100)
| | OPTN | 87.6
(87.0, 88.2)
| 95.6
(95.4, 95.8)
| 79.9
(79.3, 80.5)
| 90.8
(90.5, 91.1)
| | | One Year Graft Survival | Three Year Graft Survival | | Subjects | 81.8
(59.0, 100)
| 83.3
(66.1, 100)
| 71.6
(44.2, 99.0)
| 83.3
(66.1, 100)
| | OPTN | 82.4
(81.8, 83.1)
| 91.3
(91.0, 91.5)
| 73.5
(72.8, 74.2)
| 81.8
(81.4, 82.2)
|
2 liver recipients died of HCV-associated cirrhosis. There was 1 case each of CMV and candida esophagitis. CD4 counts were stable. CD4 cell increases were associated with baseline CD4 count (34 cells/50 cells) and time (32 cells/year); decreases were associated with age (105 cells/10 years), rejection (61 cells) and thymoglobulin use (295 cells). 1, 2 and 3 year cumulative incidence (95% CI) of rejection for kidney recipients: 52% (28%, 75%), 64% (41%, 87%) and 73% (50%, 96%). No rejection predictors were identified. Median change in creatinine at years 1, 2 and 3 = 0.0, 0.1, 0.2 mg/dL.
Conclusions: Patient and graft survival rates are similar to the overall transplant population. HCV progression is a concern. There was no significant HIV disease progression. Despite kidney rejection episodes, renal function was good.
AIDS 2006 - XVI International AIDS Conference
Abstract no.
WEPE0052
Suggested Citation
"M.Roland, et al.
HIV-infected liver and kidney transplant recipients: 1- and 3-year outcomes.
:
AIDS 2006 - XVI International AIDS Conference:
Abstract no.
WEPE0052"
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