Heart Transplantation in Human Immunodeficiency Virus–Positive Patients
Background Human immunodeficiency virus (HIV) infection is widely considered a contraindication for cardiac transplantation. However, with the newer anti-retroviral drugs, the estimated 10-year survival after seroconversion is exceeds 90%. This case series describes the intermediate range outcome of...
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| Veröffentlicht in: | The Journal of heart and lung transplantation 2009-07, Vol.28 (7), p.667-669 |
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| container_title | The Journal of heart and lung transplantation |
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| creator | Uriel, Nir, MD Jorde, Ulrich P., MD Cotarlan, Vlad, MD Colombo, Paolo C., MD Farr, Maryjane, MD Restaino, Susan W., MD Lietz, Katherine, MD Naka, Yoshifuma, MD, PhD Deng, Mario C., MD Mancini, Donna, MD |
| description | Background Human immunodeficiency virus (HIV) infection is widely considered a contraindication for cardiac transplantation. However, with the newer anti-retroviral drugs, the estimated 10-year survival after seroconversion is exceeds 90%. This case series describes the intermediate range outcome of HIV-positive cardiac transplant recipients. Methods A retrospective analysis of 1679 cardiac transplant patients was undertaken to identify HIV-positive recipients. Results Seven patients were identified. Five (4 men) were diagnosed with HIV before transplantation and 2 patients seroconverted after transplantation. Dilated cardiomyopathy was the indication for transplant in all patients. The 5 HIV recipients were aged 42 ± 8 years, and time after HIV seroconversion averaged 9.5 years. All underwent cardiac transplantation as high-risk candidates. The CD4 count was 554 ± 169 cells/μl, and viral load was undetectable in all patients at the time of transplantation. Two patients seroconverted to HIV-positive status at 1 and 7 years after transplant. No AIDS-defining illness was observed in any patient before or after transplant. Six patients received highly active anti-retroviral therapy. Viral load remained low in the presence of immunosuppression. All patients are alive with a follow-up from transplant of 57 ± 78.9 months. Conclusion Excellent intermediate term outcome is noted in carefully selected HIV-positive patients. No significant AIDS-related infections or complications occurred. |
| doi_str_mv | 10.1016/j.healun.2009.04.005 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67426788</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S1053249809002277</els_id><sourcerecordid>67426788</sourcerecordid><originalsourceid>FETCH-LOGICAL-c511t-ab5f4b08d4a475c3ad32a8dc5467a24bd86abdf0b06c5145459c9f11e5fbd893</originalsourceid><addsrcrecordid>eNqFkc1q3DAURkVJaX7aNwjFm3Rn90qWLHtTKKHJDAQa6NCtkKVrqoktTyU7MLu-Q96wTxK5MzTQTVcS6HyfLucSckmhoECrj9viB-p-9gUDaArgBYB4Rc6oEDIvKZUn6Q6izBlv6lNyHuMWAFgp2BtyShtRQdWUZ2S9Qh2mbBO0j7te-0lPbvSZ89lqHrTP1sMw-9Fi54xDb_bZdxfm-PvX0_0Y3eQeMbtPCfRTfEted7qP-O54XpDNzZfN9Sq_-3q7vv58lxtB6ZTrVnS8hdpyzaUwpbYl07U1gldSM97autKt7aCFKgW44KIxTUcpii69NeUF-XCo3YXx54xxUoOLBvs0O45zVJXkrJJ1nUB-AE0YYwzYqV1wgw57RUEtBtVWHQyqxaACrpLBFHt_7J_bAe1L6KgsAVdHQEej-y6ZMy7-5RiVrKZsKfp04DDJeHQYVPyjEK0LaCZlR_e_Sf4tML3zLv35gHuM23EOPolWVEWmQH1btr0sG5q0ZyZl-QwLkKd6</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>67426788</pqid></control><display><type>article</type><title>Heart Transplantation in Human Immunodeficiency Virus–Positive Patients</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Uriel, Nir, MD ; Jorde, Ulrich P., MD ; Cotarlan, Vlad, MD ; Colombo, Paolo C., MD ; Farr, Maryjane, MD ; Restaino, Susan W., MD ; Lietz, Katherine, MD ; Naka, Yoshifuma, MD, PhD ; Deng, Mario C., MD ; Mancini, Donna, MD</creator><creatorcontrib>Uriel, Nir, MD ; Jorde, Ulrich P., MD ; Cotarlan, Vlad, MD ; Colombo, Paolo C., MD ; Farr, Maryjane, MD ; Restaino, Susan W., MD ; Lietz, Katherine, MD ; Naka, Yoshifuma, MD, PhD ; Deng, Mario C., MD ; Mancini, Donna, MD</creatorcontrib><description>Background Human immunodeficiency virus (HIV) infection is widely considered a contraindication for cardiac transplantation. However, with the newer anti-retroviral drugs, the estimated 10-year survival after seroconversion is exceeds 90%. This case series describes the intermediate range outcome of HIV-positive cardiac transplant recipients. Methods A retrospective analysis of 1679 cardiac transplant patients was undertaken to identify HIV-positive recipients. Results Seven patients were identified. Five (4 men) were diagnosed with HIV before transplantation and 2 patients seroconverted after transplantation. Dilated cardiomyopathy was the indication for transplant in all patients. The 5 HIV recipients were aged 42 ± 8 years, and time after HIV seroconversion averaged 9.5 years. All underwent cardiac transplantation as high-risk candidates. The CD4 count was 554 ± 169 cells/μl, and viral load was undetectable in all patients at the time of transplantation. Two patients seroconverted to HIV-positive status at 1 and 7 years after transplant. No AIDS-defining illness was observed in any patient before or after transplant. Six patients received highly active anti-retroviral therapy. Viral load remained low in the presence of immunosuppression. All patients are alive with a follow-up from transplant of 57 ± 78.9 months. Conclusion Excellent intermediate term outcome is noted in carefully selected HIV-positive patients. No significant AIDS-related infections or complications occurred.</description><identifier>ISSN: 1053-2498</identifier><identifier>EISSN: 1557-3117</identifier><identifier>DOI: 10.1016/j.healun.2009.04.005</identifier><identifier>PMID: 19560693</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Antiretroviral Therapy, Highly Active ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiomyopathy, Dilated - surgery ; Female ; Follow-Up Studies ; Heart Transplantation - physiology ; Heart Transplantation - psychology ; HIV Infections - drug therapy ; HIV Infections - physiopathology ; HIV Infections - psychology ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Outcome Assessment (Health Care) ; Quality of Life - psychology ; Retrospective Studies ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Treatment Outcome ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids</subject><ispartof>The Journal of heart and lung transplantation, 2009-07, Vol.28 (7), p.667-669</ispartof><rights>International Society for Heart and Lung Transplantation</rights><rights>2009 International Society for Heart and Lung Transplantation</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c511t-ab5f4b08d4a475c3ad32a8dc5467a24bd86abdf0b06c5145459c9f11e5fbd893</citedby><cites>FETCH-LOGICAL-c511t-ab5f4b08d4a475c3ad32a8dc5467a24bd86abdf0b06c5145459c9f11e5fbd893</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1053249809002277$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21728125$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19560693$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Uriel, Nir, MD</creatorcontrib><creatorcontrib>Jorde, Ulrich P., MD</creatorcontrib><creatorcontrib>Cotarlan, Vlad, MD</creatorcontrib><creatorcontrib>Colombo, Paolo C., MD</creatorcontrib><creatorcontrib>Farr, Maryjane, MD</creatorcontrib><creatorcontrib>Restaino, Susan W., MD</creatorcontrib><creatorcontrib>Lietz, Katherine, MD</creatorcontrib><creatorcontrib>Naka, Yoshifuma, MD, PhD</creatorcontrib><creatorcontrib>Deng, Mario C., MD</creatorcontrib><creatorcontrib>Mancini, Donna, MD</creatorcontrib><title>Heart Transplantation in Human Immunodeficiency Virus–Positive Patients</title><title>The Journal of heart and lung transplantation</title><addtitle>J Heart Lung Transplant</addtitle><description>Background Human immunodeficiency virus (HIV) infection is widely considered a contraindication for cardiac transplantation. However, with the newer anti-retroviral drugs, the estimated 10-year survival after seroconversion is exceeds 90%. This case series describes the intermediate range outcome of HIV-positive cardiac transplant recipients. Methods A retrospective analysis of 1679 cardiac transplant patients was undertaken to identify HIV-positive recipients. Results Seven patients were identified. Five (4 men) were diagnosed with HIV before transplantation and 2 patients seroconverted after transplantation. Dilated cardiomyopathy was the indication for transplant in all patients. The 5 HIV recipients were aged 42 ± 8 years, and time after HIV seroconversion averaged 9.5 years. All underwent cardiac transplantation as high-risk candidates. The CD4 count was 554 ± 169 cells/μl, and viral load was undetectable in all patients at the time of transplantation. Two patients seroconverted to HIV-positive status at 1 and 7 years after transplant. No AIDS-defining illness was observed in any patient before or after transplant. Six patients received highly active anti-retroviral therapy. Viral load remained low in the presence of immunosuppression. All patients are alive with a follow-up from transplant of 57 ± 78.9 months. Conclusion Excellent intermediate term outcome is noted in carefully selected HIV-positive patients. No significant AIDS-related infections or complications occurred.</description><subject>Adult</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cardiomyopathy, Dilated - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Transplantation - physiology</subject><subject>Heart Transplantation - psychology</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - physiopathology</subject><subject>HIV Infections - psychology</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunodeficiencies</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Outcome Assessment (Health Care)</subject><subject>Quality of Life - psychology</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Treatment Outcome</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><issn>1053-2498</issn><issn>1557-3117</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1q3DAURkVJaX7aNwjFm3Rn90qWLHtTKKHJDAQa6NCtkKVrqoktTyU7MLu-Q96wTxK5MzTQTVcS6HyfLucSckmhoECrj9viB-p-9gUDaArgBYB4Rc6oEDIvKZUn6Q6izBlv6lNyHuMWAFgp2BtyShtRQdWUZ2S9Qh2mbBO0j7te-0lPbvSZ89lqHrTP1sMw-9Fi54xDb_bZdxfm-PvX0_0Y3eQeMbtPCfRTfEted7qP-O54XpDNzZfN9Sq_-3q7vv58lxtB6ZTrVnS8hdpyzaUwpbYl07U1gldSM97autKt7aCFKgW44KIxTUcpii69NeUF-XCo3YXx54xxUoOLBvs0O45zVJXkrJJ1nUB-AE0YYwzYqV1wgw57RUEtBtVWHQyqxaACrpLBFHt_7J_bAe1L6KgsAVdHQEej-y6ZMy7-5RiVrKZsKfp04DDJeHQYVPyjEK0LaCZlR_e_Sf4tML3zLv35gHuM23EOPolWVEWmQH1btr0sG5q0ZyZl-QwLkKd6</recordid><startdate>20090701</startdate><enddate>20090701</enddate><creator>Uriel, Nir, MD</creator><creator>Jorde, Ulrich P., MD</creator><creator>Cotarlan, Vlad, MD</creator><creator>Colombo, Paolo C., MD</creator><creator>Farr, Maryjane, MD</creator><creator>Restaino, Susan W., MD</creator><creator>Lietz, Katherine, MD</creator><creator>Naka, Yoshifuma, MD, PhD</creator><creator>Deng, Mario C., MD</creator><creator>Mancini, Donna, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090701</creationdate><title>Heart Transplantation in Human Immunodeficiency Virus–Positive Patients</title><author>Uriel, Nir, MD ; Jorde, Ulrich P., MD ; Cotarlan, Vlad, MD ; Colombo, Paolo C., MD ; Farr, Maryjane, MD ; Restaino, Susan W., MD ; Lietz, Katherine, MD ; Naka, Yoshifuma, MD, PhD ; Deng, Mario C., MD ; Mancini, Donna, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c511t-ab5f4b08d4a475c3ad32a8dc5467a24bd86abdf0b06c5145459c9f11e5fbd893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiomyopathy, Dilated - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Transplantation - physiology</topic><topic>Heart Transplantation - psychology</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - physiopathology</topic><topic>HIV Infections - psychology</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunodeficiencies</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Outcome Assessment (Health Care)</topic><topic>Quality of Life - psychology</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Treatment Outcome</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Uriel, Nir, MD</creatorcontrib><creatorcontrib>Jorde, Ulrich P., MD</creatorcontrib><creatorcontrib>Cotarlan, Vlad, MD</creatorcontrib><creatorcontrib>Colombo, Paolo C., MD</creatorcontrib><creatorcontrib>Farr, Maryjane, MD</creatorcontrib><creatorcontrib>Restaino, Susan W., MD</creatorcontrib><creatorcontrib>Lietz, Katherine, MD</creatorcontrib><creatorcontrib>Naka, Yoshifuma, MD, PhD</creatorcontrib><creatorcontrib>Deng, Mario C., MD</creatorcontrib><creatorcontrib>Mancini, Donna, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of heart and lung transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Uriel, Nir, MD</au><au>Jorde, Ulrich P., MD</au><au>Cotarlan, Vlad, MD</au><au>Colombo, Paolo C., MD</au><au>Farr, Maryjane, MD</au><au>Restaino, Susan W., MD</au><au>Lietz, Katherine, MD</au><au>Naka, Yoshifuma, MD, PhD</au><au>Deng, Mario C., MD</au><au>Mancini, Donna, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Heart Transplantation in Human Immunodeficiency Virus–Positive Patients</atitle><jtitle>The Journal of heart and lung transplantation</jtitle><addtitle>J Heart Lung Transplant</addtitle><date>2009-07-01</date><risdate>2009</risdate><volume>28</volume><issue>7</issue><spage>667</spage><epage>669</epage><pages>667-669</pages><issn>1053-2498</issn><eissn>1557-3117</eissn><abstract>Background Human immunodeficiency virus (HIV) infection is widely considered a contraindication for cardiac transplantation. However, with the newer anti-retroviral drugs, the estimated 10-year survival after seroconversion is exceeds 90%. This case series describes the intermediate range outcome of HIV-positive cardiac transplant recipients. Methods A retrospective analysis of 1679 cardiac transplant patients was undertaken to identify HIV-positive recipients. Results Seven patients were identified. Five (4 men) were diagnosed with HIV before transplantation and 2 patients seroconverted after transplantation. Dilated cardiomyopathy was the indication for transplant in all patients. The 5 HIV recipients were aged 42 ± 8 years, and time after HIV seroconversion averaged 9.5 years. All underwent cardiac transplantation as high-risk candidates. The CD4 count was 554 ± 169 cells/μl, and viral load was undetectable in all patients at the time of transplantation. Two patients seroconverted to HIV-positive status at 1 and 7 years after transplant. No AIDS-defining illness was observed in any patient before or after transplant. Six patients received highly active anti-retroviral therapy. Viral load remained low in the presence of immunosuppression. All patients are alive with a follow-up from transplant of 57 ± 78.9 months. Conclusion Excellent intermediate term outcome is noted in carefully selected HIV-positive patients. No significant AIDS-related infections or complications occurred.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19560693</pmid><doi>10.1016/j.healun.2009.04.005</doi><tpages>3</tpages></addata></record> |
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| subjects | Adult Antiretroviral Therapy, Highly Active Biological and medical sciences Cardiology. Vascular system Cardiomyopathy, Dilated - surgery Female Follow-Up Studies Heart Transplantation - physiology Heart Transplantation - psychology HIV Infections - drug therapy HIV Infections - physiopathology HIV Infections - psychology Human viral diseases Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infectious diseases Male Medical sciences Middle Aged Outcome Assessment (Health Care) Quality of Life - psychology Retrospective Studies Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Treatment Outcome Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| title | Heart Transplantation in Human Immunodeficiency Virus–Positive Patients |
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