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SHR Neuro Cancer Cardio Lipid Metab Microb
Vernadakis, S; Sotiropoulos, GC; Brokalaki, EI; Esser, S; Kaiser, GM; Cicinnati, VR; Beckebaum, S; Paul, A; Mathé, Z.
Long-term outcomes of liver transplant patients with human immunodeficiency virus infection and end-stage-liver-disease: single center experience.
Eur J Med Res. 2011; 16(8):342-348
Doi: 10.1186/2047-783x-16-8-342
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- Co-authors Med Uni Graz
- Mathe Zoltan
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- Abstract:
- Orthotopic-liver-transplantation (OLT) in patients with Human-Immunodeficiency-Virus infection (HIV) and end-stage-liver-disease (ESDL) is rarely reported. The purpose of this study is to describe our institutional experience on OLT for HIV positive patients. This is a retrospective study of all HIV-infected patients who underwent OLT at the University Hospital of Essen, from January 1996 to December 2009. Age, sex, HIV transmission-way, CDC-stage, etiology of ESDL, concomitant liver disease, last CD4cell count and HIV-viral load prior to OLT were collected and analysed. Standard calcineurin-inhibitors-based immunosuppression was applied. All patients received anti-fungal and anti-pneumocystis carinii pneumonia prophylaxis post-OLT. Eight transplanted HIV-infected patients with a median age of 46 years (range 35-61years) were included. OLT indications were HCV (n = 5), HBV (n = 2), HCV/HBV/HDV-related cirrhosis (n = 1) and acute liver-failure (n = 1). At OLT, CD4 cell-counts ranged from 113-621 cells/μl, and HIV viral-loads from <50-175,000 copies/ml. Seven of eight patients were exposed to HAART before OLT. Patients were followed-up between 1-145 months. Five died 1, 3, 10, 31 and 34 months after OLT due to sepsis and graft-failure respectively. Graft-failure causes were recurrent hepatic-artery thrombosis, HCV-associated hepatitis and chemotherapy-induced liver damage due to Hodgkin-disease. One survivor is relisted for OLT due to recurrent chronic HCV-disease but non-progredient HIV-infection 145 months post-OLT. Two other survivors show stable liver function and non-progredient HIV-disease under HAART 21 and 58 months post-OLT. OLT in HIV-infected patients and ESLD is an acceptable therapeutic option in selected patients. Long-term survival can be achieved without HIV disease-progression under antiretroviral therapy and management of the viral hepatitis co-infection.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Aged -
- Antiretroviral Therapy, Highly Active -
- CD4-Positive T-Lymphocytes - virology
- End Stage Liver Disease - complications
- End Stage Liver Disease - therapy
- Female -
- HIV Infections - complications
- HIV Infections - therapy
- Humans -
- Liver Transplantation - methods
- Male -
- Middle Aged -
- Recurrence -
- Retrospective Studies -
- Time Factors -
- Treatment Outcome -
- Find related publications in this database (Keywords)
- Human immunodeficiency virus
- HIV infection
- hepatocellular carcinoma
- liver transplantation
- liver cirrhosis
- highly active antiretroviral therapy
- HAART
- hepatitis C
- HCV infection