Long-Term Outcomes of Orthotopic Liver Transplantation in Human Immunodeficiency Virus–Infected Patients and Comparison With Human Immunodeficiency Virus–Negative Cases
Abstract Human immunodeficiency virus (HIV) positivity is no longer a contraindication for orthotopic liver transplantation (OLT) due to the efficacy of antiretroviral therapy. The aim of this study was to compare OLT among HIV-positive and HIV-negative cohorts; the results were also stratified for...
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| Veröffentlicht in: | Transplantation proceedings 2011-05, Vol.43 (4), p.1119-1122 |
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| creator | Baccarani, U Adani, G.L Bragantini, F Londero, A Comuzzi, C Rossetto, A Lorenzin, D Bresadola, V Risaliti, A Pea, F Toniutto, P Donini, A De Anna, D Bresadola, F Tavio, M Viale, P |
| description | Abstract Human immunodeficiency virus (HIV) positivity is no longer a contraindication for orthotopic liver transplantation (OLT) due to the efficacy of antiretroviral therapy. The aim of this study was to compare OLT among HIV-positive and HIV-negative cohorts; the results were also stratified for hepatitis C virus (HCV) coinfection. Between 2004 and 2009, all HIV-infected patients undergoing OLT from heart-beating deceased donors (n = 27) were compared with an HIV-negative cohort (n = 27). The pure HCV infection rate was similar between HIV-positive and HIV-negative subjects (63% each). HIV-positive recipients were younger ( P = .013). The CD4 count for HIV-positive subjects was 376 ± 156 at transplantation. The mean model for end-stage liver disease (MELD) score at transplantation was 15 ± 7 in both groups ( P = .92). No differences were observed for donor age ( P = .72) or time on the waiting list ( P = .56). The median follow-up was 26 (range, 1–64) and 27 months (range, 1–48) for HIV and non-HIV recipients, respectively ( P = .85). The estimated 1-, 3-, and 5-year patient and graft survival rates were 88%, 83%, and 83% versus 100%, 73%, and 73% ( P = .95), and 92%, 87%, and 87% versus 95%, 88%, and 88% ( P = .59) for HIV and non-HIV cases, respectively. HIV/HCV–coinfected patients were younger, namely 47 (range, 40–53) versus 52 years (range, 37–68; P = .003), and displayed lower MELD scores at transplantation compared with HCV–mono-infected patients 10 (range, 7–19) versus 17 (range, 8–30) ( P = .008). For HIV/HCV–coinfected and HCV–mono-infected cases the estimated 1-, 3-, and 5-year patients and graft survival rates were respectively 93%, 76%, and 76% versus 100%, 70%, and 60% ( P = .99) and 93%, 84%, and 84% versus 100%, 70%, and 60% ( P = .64), respectively. No difference was observed in the histological severity of HCV recurrence. In conclusion, under specific, well-determined conditions, OLT can be a safe, efficacious procedure in HIV patients. |
| doi_str_mv | 10.1016/j.transproceed.2011.01.124 |
| format | Article |
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The aim of this study was to compare OLT among HIV-positive and HIV-negative cohorts; the results were also stratified for hepatitis C virus (HCV) coinfection. Between 2004 and 2009, all HIV-infected patients undergoing OLT from heart-beating deceased donors (n = 27) were compared with an HIV-negative cohort (n = 27). The pure HCV infection rate was similar between HIV-positive and HIV-negative subjects (63% each). HIV-positive recipients were younger ( P = .013). The CD4 count for HIV-positive subjects was 376 ± 156 at transplantation. The mean model for end-stage liver disease (MELD) score at transplantation was 15 ± 7 in both groups ( P = .92). No differences were observed for donor age ( P = .72) or time on the waiting list ( P = .56). The median follow-up was 26 (range, 1–64) and 27 months (range, 1–48) for HIV and non-HIV recipients, respectively ( P = .85). The estimated 1-, 3-, and 5-year patient and graft survival rates were 88%, 83%, and 83% versus 100%, 73%, and 73% ( P = .95), and 92%, 87%, and 87% versus 95%, 88%, and 88% ( P = .59) for HIV and non-HIV cases, respectively. HIV/HCV–coinfected patients were younger, namely 47 (range, 40–53) versus 52 years (range, 37–68; P = .003), and displayed lower MELD scores at transplantation compared with HCV–mono-infected patients 10 (range, 7–19) versus 17 (range, 8–30) ( P = .008). For HIV/HCV–coinfected and HCV–mono-infected cases the estimated 1-, 3-, and 5-year patients and graft survival rates were respectively 93%, 76%, and 76% versus 100%, 70%, and 60% ( P = .99) and 93%, 84%, and 84% versus 100%, 70%, and 60% ( P = .64), respectively. No difference was observed in the histological severity of HCV recurrence. In conclusion, under specific, well-determined conditions, OLT can be a safe, efficacious procedure in HIV patients.</description><identifier>ISSN: 0041-1345</identifier><identifier>EISSN: 1873-2623</identifier><identifier>DOI: 10.1016/j.transproceed.2011.01.124</identifier><identifier>PMID: 21620067</identifier><identifier>CODEN: TRPPA8</identifier><language>eng</language><publisher>Amsterdam: Elsevier Inc</publisher><subject>Adult ; Aged ; Antiretroviral Therapy, Highly Active ; Biological and medical sciences ; Case-Control Studies ; Chi-Square Distribution ; End Stage Liver Disease - diagnosis ; End Stage Liver Disease - etiology ; End Stage Liver Disease - mortality ; End Stage Liver Disease - surgery ; Female ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Graft Survival ; Hepatitis C - complications ; HIV Infections - complications ; HIV Infections - diagnosis ; HIV Infections - drug therapy ; HIV Infections - mortality ; Human viral diseases ; Humans ; Infectious diseases ; Italy ; Kaplan-Meier Estimate ; Liver Transplantation - adverse effects ; Liver Transplantation - mortality ; Liver, biliary tract, pancreas, portal circulation, spleen ; Male ; Medical sciences ; Middle Aged ; Patient Selection ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Survival Rate ; Time Factors ; Tissue, organ and graft immunology ; Treatment Outcome ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids</subject><ispartof>Transplantation proceedings, 2011-05, Vol.43 (4), p.1119-1122</ispartof><rights>Elsevier Inc.</rights><rights>2011 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-89f2bf43fe51af7fabcd9f2e25b8ad8540ceb37fb55f4e51635ef543ed8779e3</citedby><cites>FETCH-LOGICAL-c464t-89f2bf43fe51af7fabcd9f2e25b8ad8540ceb37fb55f4e51635ef543ed8779e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0041134511002089$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,23909,23910,25118,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24220159$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21620067$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baccarani, U</creatorcontrib><creatorcontrib>Adani, G.L</creatorcontrib><creatorcontrib>Bragantini, F</creatorcontrib><creatorcontrib>Londero, A</creatorcontrib><creatorcontrib>Comuzzi, C</creatorcontrib><creatorcontrib>Rossetto, A</creatorcontrib><creatorcontrib>Lorenzin, D</creatorcontrib><creatorcontrib>Bresadola, V</creatorcontrib><creatorcontrib>Risaliti, A</creatorcontrib><creatorcontrib>Pea, F</creatorcontrib><creatorcontrib>Toniutto, P</creatorcontrib><creatorcontrib>Donini, A</creatorcontrib><creatorcontrib>De Anna, D</creatorcontrib><creatorcontrib>Bresadola, F</creatorcontrib><creatorcontrib>Tavio, M</creatorcontrib><creatorcontrib>Viale, P</creatorcontrib><title>Long-Term Outcomes of Orthotopic Liver Transplantation in Human Immunodeficiency Virus–Infected Patients and Comparison With Human Immunodeficiency Virus–Negative Cases</title><title>Transplantation proceedings</title><addtitle>Transplant Proc</addtitle><description>Abstract Human immunodeficiency virus (HIV) positivity is no longer a contraindication for orthotopic liver transplantation (OLT) due to the efficacy of antiretroviral therapy. The aim of this study was to compare OLT among HIV-positive and HIV-negative cohorts; the results were also stratified for hepatitis C virus (HCV) coinfection. Between 2004 and 2009, all HIV-infected patients undergoing OLT from heart-beating deceased donors (n = 27) were compared with an HIV-negative cohort (n = 27). The pure HCV infection rate was similar between HIV-positive and HIV-negative subjects (63% each). HIV-positive recipients were younger ( P = .013). The CD4 count for HIV-positive subjects was 376 ± 156 at transplantation. The mean model for end-stage liver disease (MELD) score at transplantation was 15 ± 7 in both groups ( P = .92). No differences were observed for donor age ( P = .72) or time on the waiting list ( P = .56). The median follow-up was 26 (range, 1–64) and 27 months (range, 1–48) for HIV and non-HIV recipients, respectively ( P = .85). The estimated 1-, 3-, and 5-year patient and graft survival rates were 88%, 83%, and 83% versus 100%, 73%, and 73% ( P = .95), and 92%, 87%, and 87% versus 95%, 88%, and 88% ( P = .59) for HIV and non-HIV cases, respectively. HIV/HCV–coinfected patients were younger, namely 47 (range, 40–53) versus 52 years (range, 37–68; P = .003), and displayed lower MELD scores at transplantation compared with HCV–mono-infected patients 10 (range, 7–19) versus 17 (range, 8–30) ( P = .008). For HIV/HCV–coinfected and HCV–mono-infected cases the estimated 1-, 3-, and 5-year patients and graft survival rates were respectively 93%, 76%, and 76% versus 100%, 70%, and 60% ( P = .99) and 93%, 84%, and 84% versus 100%, 70%, and 60% ( P = .64), respectively. No difference was observed in the histological severity of HCV recurrence. In conclusion, under specific, well-determined conditions, OLT can be a safe, efficacious procedure in HIV patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>Chi-Square Distribution</subject><subject>End Stage Liver Disease - diagnosis</subject><subject>End Stage Liver Disease - etiology</subject><subject>End Stage Liver Disease - mortality</subject><subject>End Stage Liver Disease - surgery</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Graft Survival</subject><subject>Hepatitis C - complications</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - mortality</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Italy</subject><subject>Kaplan-Meier Estimate</subject><subject>Liver Transplantation - adverse effects</subject><subject>Liver Transplantation - mortality</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patient Selection</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Tissue, organ and graft immunology</subject><subject>Treatment Outcome</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><issn>0041-1345</issn><issn>1873-2623</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNksuKFDEUhgtRnHb0FSQI4qpqcqubC0HayzQ0tmCjy5BKncykrUraJNXQO9_B1_CpfJJJT_eguNFVSPKd_yT_f7LsGcEFwaS62BTRSxu23imAvqCYkAKTglB-L5uRpmY5rSi7n80w5iQnjJdn2aMQNjjtKWcPszNKKopxVc-yn0tnr_I1-BGtpqjcCAE5jVY-XrvotkahpdmBR-vbjoO0UUbjLDIWXU6jtGgxjpN1PWijDFi1R5-Nn8Kv7z8WVoOK0KOPqQJsDEjaHs3duJXehCTxxcTrf4l8gKtUvQM0lwHC4-yBlkOAJ6f1PFu_e7ueX-bL1fvF_PUyV7ziMW9aTTvNmYaSSF1r2ak-HQEtu0b2Tcmxgo7VuitLzRNTsRJ0yRn0TV23wM6zF0fZ5PC3CUIUowkKhvR7cFMQTdVyzFlTJfLlkVTeheBBi603o_R7QbA4ZCU24s-sxCErgYlIWaXip6c2Uzemu7vSu3AS8PwEyKDkoJOQMuE3x2mSK9vEvTlykDzZGfAi3NoIvfEpAtE783_vefWXjBqMNanzV9hD2LjJ2-S6ICJQgcWnw3QdhosQjCluWnYDLo_VeQ</recordid><startdate>20110501</startdate><enddate>20110501</enddate><creator>Baccarani, U</creator><creator>Adani, G.L</creator><creator>Bragantini, F</creator><creator>Londero, A</creator><creator>Comuzzi, C</creator><creator>Rossetto, A</creator><creator>Lorenzin, D</creator><creator>Bresadola, V</creator><creator>Risaliti, A</creator><creator>Pea, F</creator><creator>Toniutto, P</creator><creator>Donini, A</creator><creator>De Anna, D</creator><creator>Bresadola, F</creator><creator>Tavio, M</creator><creator>Viale, P</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>20110501</creationdate><title>Long-Term Outcomes of Orthotopic Liver Transplantation in Human Immunodeficiency Virus–Infected Patients and Comparison With Human Immunodeficiency Virus–Negative Cases</title><author>Baccarani, U ; Adani, G.L ; Bragantini, F ; Londero, A ; Comuzzi, C ; Rossetto, A ; Lorenzin, D ; Bresadola, V ; Risaliti, A ; Pea, F ; Toniutto, P ; Donini, A ; De Anna, D ; Bresadola, F ; Tavio, M ; Viale, P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-89f2bf43fe51af7fabcd9f2e25b8ad8540ceb37fb55f4e51635ef543ed8779e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Biological and medical sciences</topic><topic>Case-Control Studies</topic><topic>Chi-Square Distribution</topic><topic>End Stage Liver Disease - diagnosis</topic><topic>End Stage Liver Disease - etiology</topic><topic>End Stage Liver Disease - mortality</topic><topic>End Stage Liver Disease - surgery</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Graft Survival</topic><topic>Hepatitis C - complications</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - diagnosis</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - mortality</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Italy</topic><topic>Kaplan-Meier Estimate</topic><topic>Liver Transplantation - adverse effects</topic><topic>Liver Transplantation - mortality</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patient Selection</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baccarani, U</creatorcontrib><creatorcontrib>Adani, G.L</creatorcontrib><creatorcontrib>Bragantini, F</creatorcontrib><creatorcontrib>Londero, A</creatorcontrib><creatorcontrib>Comuzzi, C</creatorcontrib><creatorcontrib>Rossetto, A</creatorcontrib><creatorcontrib>Lorenzin, D</creatorcontrib><creatorcontrib>Bresadola, V</creatorcontrib><creatorcontrib>Risaliti, A</creatorcontrib><creatorcontrib>Pea, F</creatorcontrib><creatorcontrib>Toniutto, P</creatorcontrib><creatorcontrib>Donini, A</creatorcontrib><creatorcontrib>De Anna, D</creatorcontrib><creatorcontrib>Bresadola, F</creatorcontrib><creatorcontrib>Tavio, M</creatorcontrib><creatorcontrib>Viale, P</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>Transplantation proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baccarani, U</au><au>Adani, G.L</au><au>Bragantini, F</au><au>Londero, A</au><au>Comuzzi, C</au><au>Rossetto, A</au><au>Lorenzin, D</au><au>Bresadola, V</au><au>Risaliti, A</au><au>Pea, F</au><au>Toniutto, P</au><au>Donini, A</au><au>De Anna, D</au><au>Bresadola, F</au><au>Tavio, M</au><au>Viale, P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Outcomes of Orthotopic Liver Transplantation in Human Immunodeficiency Virus–Infected Patients and Comparison With Human Immunodeficiency Virus–Negative Cases</atitle><jtitle>Transplantation proceedings</jtitle><addtitle>Transplant Proc</addtitle><date>2011-05-01</date><risdate>2011</risdate><volume>43</volume><issue>4</issue><spage>1119</spage><epage>1122</epage><pages>1119-1122</pages><issn>0041-1345</issn><eissn>1873-2623</eissn><coden>TRPPA8</coden><abstract>Abstract Human immunodeficiency virus (HIV) positivity is no longer a contraindication for orthotopic liver transplantation (OLT) due to the efficacy of antiretroviral therapy. The aim of this study was to compare OLT among HIV-positive and HIV-negative cohorts; the results were also stratified for hepatitis C virus (HCV) coinfection. Between 2004 and 2009, all HIV-infected patients undergoing OLT from heart-beating deceased donors (n = 27) were compared with an HIV-negative cohort (n = 27). The pure HCV infection rate was similar between HIV-positive and HIV-negative subjects (63% each). HIV-positive recipients were younger ( P = .013). The CD4 count for HIV-positive subjects was 376 ± 156 at transplantation. The mean model for end-stage liver disease (MELD) score at transplantation was 15 ± 7 in both groups ( P = .92). No differences were observed for donor age ( P = .72) or time on the waiting list ( P = .56). The median follow-up was 26 (range, 1–64) and 27 months (range, 1–48) for HIV and non-HIV recipients, respectively ( P = .85). The estimated 1-, 3-, and 5-year patient and graft survival rates were 88%, 83%, and 83% versus 100%, 73%, and 73% ( P = .95), and 92%, 87%, and 87% versus 95%, 88%, and 88% ( P = .59) for HIV and non-HIV cases, respectively. HIV/HCV–coinfected patients were younger, namely 47 (range, 40–53) versus 52 years (range, 37–68; P = .003), and displayed lower MELD scores at transplantation compared with HCV–mono-infected patients 10 (range, 7–19) versus 17 (range, 8–30) ( P = .008). For HIV/HCV–coinfected and HCV–mono-infected cases the estimated 1-, 3-, and 5-year patients and graft survival rates were respectively 93%, 76%, and 76% versus 100%, 70%, and 60% ( P = .99) and 93%, 84%, and 84% versus 100%, 70%, and 60% ( P = .64), respectively. No difference was observed in the histological severity of HCV recurrence. In conclusion, under specific, well-determined conditions, OLT can be a safe, efficacious procedure in HIV patients.</abstract><cop>Amsterdam</cop><pub>Elsevier Inc</pub><pmid>21620067</pmid><doi>10.1016/j.transproceed.2011.01.124</doi><tpages>4</tpages></addata></record> |
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| subjects | Adult Aged Antiretroviral Therapy, Highly Active Biological and medical sciences Case-Control Studies Chi-Square Distribution End Stage Liver Disease - diagnosis End Stage Liver Disease - etiology End Stage Liver Disease - mortality End Stage Liver Disease - surgery Female Fundamental and applied biological sciences. Psychology Fundamental immunology Graft Survival Hepatitis C - complications HIV Infections - complications HIV Infections - diagnosis HIV Infections - drug therapy HIV Infections - mortality Human viral diseases Humans Infectious diseases Italy Kaplan-Meier Estimate Liver Transplantation - adverse effects Liver Transplantation - mortality Liver, biliary tract, pancreas, portal circulation, spleen Male Medical sciences Middle Aged Patient Selection Retrospective Studies Risk Assessment Risk Factors Severity of Illness Index Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Survival Rate Time Factors Tissue, organ and graft immunology Treatment Outcome Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| title | Long-Term Outcomes of Orthotopic Liver Transplantation in Human Immunodeficiency Virus–Infected Patients and Comparison With Human Immunodeficiency Virus–Negative Cases |
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