Kidney transplantation and waiting list for renal transplantation for human immunodeficiency virus patients

Transplant Proc. 2011 Jul-Aug;43(6):2179-81. doi: 10.1016/j.transproceed.2011.05.024.

Abstract

Introduction: The aim of this study was to evaluate the experience of a renal transplantation unit in the management of human immunodeficiency virus (HIV)-infected patients with end-stage renal disease (ESRD).

Methods: A prospective study was performed between 2005 and 2010 among 23 patients with ESRD.

Results: In this study 83% of HIV-infected patients with ESRD were included on the waiting list for renal transplantation with 4 patients in a clinical evaluation phase. During the follow-up, 52% of waiting list patients (n = 11) received a renal transplant, and 1 patient underwent a simultaneous kidney-pancreas transplantation. Among the waiting list group we observed a significant later exclusion (43%; n = 3). Among the transplanted group there was a high but clinically inconsequential prevalence of acute tubular necrosis (36%; n = 4) and acute rejection episodes (36%; n = 4). The renal function showed a serum creatinine of 1.1 mg/dL at a follow-up of 24 + 12 months. All patients on the waiting list and after the transplantation are prescribed combined antiretroviral treatment (cART) with a low viral load <50 with CD4 >200.

Conclusions: HIV-infected patients with ESRD should be considered to be candidates for renal transplantation if they meet the HIV inclusion criteria. Renal transplantation in adequately selected HIV-infected patients is a safe procedure with acceptable patient and graft survivals.

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use
  • Biomarkers / blood
  • Creatinine / blood
  • Female
  • Graft Rejection / blood
  • Graft Rejection / immunology
  • Graft Survival
  • HIV Infections / complications*
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy
  • HIV Infections / mortality
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation* / adverse effects
  • Kidney Transplantation* / immunology
  • Kidney Transplantation* / mortality
  • Kidney Tubular Necrosis, Acute / etiology
  • Male
  • Middle Aged
  • Patient Selection
  • Prospective Studies
  • Spain
  • Survival Analysis
  • Survival Rate
  • Time Factors
  • Treatment Outcome
  • Waiting Lists* / mortality

Substances

  • Anti-HIV Agents
  • Biomarkers
  • Creatinine