Liver transplantation in adults coinfected with hiv

[Guest guest]

Transplantation 2001 Nov 27;72(10):1684-8

Liver transplantation in adults coinfected with hiv.

Prachalias AA, Pozniak A, C, Srinivasan P, Muiesan P, Wendon J, Cramp

M, R, O'Grady J, Rela M, Heaton ND

5 Address correspondence to: Mr. N. D. Heaton, MB BS, FRCS, Consultant

Surgeon, Liver Transplant Surgical Service, Institute of Liver Studies,

King's College Hospital, Denmark Hill, London, SE5 9RS, United Kingdom.

[Medline record in process]

OBJECTIVE: To report our experience of prospectively identifying and

transplanting livers into HIV-positive patients. DESIGN: Liver

transplantation in HIV-positive patients remains controversial. The finding

of HIV is usually considered a contraindication to any form of

transplantation. Previously reported cases are few and refer to patients who

tested HIV positive after they had their liver transplantations or who

seroconverted in the posttransplantation period. This is, to our knowledge,

the only report of patients who were known to be HIV positive at the time of

decision for listing for transplantation. METHODS: The medical records of

five HIV-positive patients who received liver transplants in King's College

Hospital, London, during a 5-year period (January 1995-December 1999) were

reviewed. All five were known to be HIV positive at the time of listing for

liver replacement. Three of them had end-stage liver disease due to

hepatitis C (two of them had underlying Hemophilia A) while the other two

had acute liver failure, one due to hepatitis B infection and one due to

nonA-nonB-nonC hepatitis. In all but one patient the HIV infection had been

asymptomatic. RESULTS: All patients survived the immediate

posttransplantation period, but the three patients with hepatitis C died of

complications of recurrent hepatitis C between 6 and 25 months

posttransplantation. The other two patients are currently alive 4 and 34

months posttransplantation with good graft function and without

complications from their HIV infection. CONCLUSION: The early outcome of

liver transplantation in HIV seropositive patients can be good, and patients

should not be excluded from transplantation if their liver disease

determines their prognosis. More effective antiviral therapy for hepatitis C

given posttransplantation, and for hepatitis B reinfection, should improve

the longer-term outcome of HIV patients with end-stage liver disease due to

hepatitis.

PMID: 11726833, UI: 21584209

[Guest guest]

Transplantation 2001 Nov 27;72(10):1684-8

Liver transplantation in adults coinfected with hiv.

Prachalias AA, Pozniak A, C, Srinivasan P, Muiesan P, Wendon J, Cramp

M, R, O'Grady J, Rela M, Heaton ND

5 Address correspondence to: Mr. N. D. Heaton, MB BS, FRCS, Consultant

Surgeon, Liver Transplant Surgical Service, Institute of Liver Studies,

King's College Hospital, Denmark Hill, London, SE5 9RS, United Kingdom.

[Medline record in process]

OBJECTIVE: To report our experience of prospectively identifying and

transplanting livers into HIV-positive patients. DESIGN: Liver

transplantation in HIV-positive patients remains controversial. The finding

of HIV is usually considered a contraindication to any form of

transplantation. Previously reported cases are few and refer to patients who

tested HIV positive after they had their liver transplantations or who

seroconverted in the posttransplantation period. This is, to our knowledge,

the only report of patients who were known to be HIV positive at the time of

decision for listing for transplantation. METHODS: The medical records of

five HIV-positive patients who received liver transplants in King's College

Hospital, London, during a 5-year period (January 1995-December 1999) were

reviewed. All five were known to be HIV positive at the time of listing for

liver replacement. Three of them had end-stage liver disease due to

hepatitis C (two of them had underlying Hemophilia A) while the other two

had acute liver failure, one due to hepatitis B infection and one due to

nonA-nonB-nonC hepatitis. In all but one patient the HIV infection had been

asymptomatic. RESULTS: All patients survived the immediate

posttransplantation period, but the three patients with hepatitis C died of

complications of recurrent hepatitis C between 6 and 25 months

posttransplantation. The other two patients are currently alive 4 and 34

months posttransplantation with good graft function and without

complications from their HIV infection. CONCLUSION: The early outcome of

liver transplantation in HIV seropositive patients can be good, and patients

should not be excluded from transplantation if their liver disease

determines their prognosis. More effective antiviral therapy for hepatitis C

given posttransplantation, and for hepatitis B reinfection, should improve

the longer-term outcome of HIV patients with end-stage liver disease due to

hepatitis.

PMID: 11726833, UI: 21584209