Seattle -- Early findings from a multi-site study led by UCSF investigators show that 95% of the HIV-infected patients in the study who received kidney transplants and 84% who received liver transplants in this era of Highly Active Anti-Retroviral Therapy (HAART), are surviving nearly one year post-transplant—rates comparable to non-HIV-infected kidney and liver transplant recipients for the same period.
The study, which looked at 41 HIV-infected patients who have received liver and kidney transplants, also showed comparable rates for grafted organ function with 89% of the kidney grafts and 84% of the liver grafts functioning nearly one year post-transplant in the HIV-infected recipients. The findings, collected retrospectively from UCSF and collaborating transplant centers around the country, were presented at the 9th Conference on Retroviruses and Opportunistic Infections.
“HIV disease does not seem to be progressing at an appreciable rate post-transplant in eligible subjects—those without a history of opportunistic infections, with relatively preserved CD4 T-cell counts, and suppressed or suppressible HIV virus,” said the study’s lead investigator, Michelle E. Roland, MD, UCSF assistant professor of medicine in the Positive Health Program at San Francisco General Hospital Medical Center.
“With the caveats that this data is retrospective—a prospective study is in process—and very preliminary, we can say that the news so far is extremely good for those subjects who met the eligible subject criteria,” said study co-investigator, Peter G. Stock, MD, UCSF associate professor of surgery.
“In addition, we noted data on 8 HIV-infected subjects who received transplants—6 kidney, 2 liver—but who did not meet the study eligibility criteria and were not part of the 41 included in the study. Two—one liver recipient, one kidney recipient—of those patients died,” said Roland.
Of the 19 study-eligible patients who received liver transplants, 16 have survived. Twenty-one of the 22 study-eligible patients who received kidneys have survived. The comparable rates for non-HIV-infected patients from the United Network for Organ Sharing (UNOS)—the government-funded clearinghouse that keeps the waiting lists governing who gets organs—were 87.9% survival rates for liver recipients, 94.8% for recipients of kidneys from cadavers and 97.6% for recipients of kidneys from a living donor.
Co-investigators include Laurie L. Carlson, RN, transplant study coordinator, UCSF’s division of transplant surgery; Margaret Ragni, M.D., M.P.H., professor of medicine, University of Pittsburgh, director of the Hemophilia Center of Western Pennsylvania; Susie R. Rohal, RN, BSN, CCTC, clinical research coordinator, Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center; Marla Keller, MD, HIV specialist at the AIDS Center, Jeffrey Jacobson, MD, director of the AIDS Center, and Leona Kim-Schluger, MD, hepatologist, Mount Sinai Medical Center; Barbara Murphey, MD, assistant professor of medicine in the renal division, Mount Sinai School of Medicine; Abhinav Humar, MD, assistant professor of surgery, University of Minnesota; Timothy Pruett, MD, chief of transplantation, and Carl Berg, MD, hepatologist, University of Virginia; Amy Lu, MD, assistant professor of surgery, Georgetown University; William D. Bennett, MD, medical director of the transplant center, Maggie Allee, RN, director of Legacy Organ Transplant Services, Legacy Good Samaritan Hospital, Portland, Oregon; Kim Olthoff, MD, program director of liver transplantation, Children’s Hospital of Philadelphia, assistant professor of surgery, University of Pennsylvania; Anil Mysore Kumar, MD, MBBS, professor of medicine, Marla J.Gold, MD, associate professor of medicine, Anna Damask, RN, transplant study coordinator, MCP Hahnemann University; Jimmy A. Light, MD, director of the Transplant Research Center, Washington Hospital Center, Washington D.C.; Robert Redfield, MD, professor of medicine, associate director of the Institute of Human Virology, University of Maryland; Christopher B.Hughes, MD, transplant surgeon, Mayo Clinic, Jacksonville, Florida; David Simon, MD, associate professor of internal medicine, Rush University.
This study was supported by grants from the University-Wide AIDS Research Program of the State of California and the National Institutes for Health.
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