Solid-organ transplantation in HIV-infected patients in the potent antiretroviral therapy era.

Improvements in antiretroviral therapy, opportunistic infection prophylaxis, and antirejection treatment have made solid-organ transplantation a potential option for HIV-infected patients. Preliminary experience in a small group of kidney and liver transplant recipients suggests that CD4+ cell counts and plasma HIV RNA level suppression can be maintained. As few opportunistic infections have been seen, as history of some opportunistic infection conditions may not be a contraindication to transplantation; this question is under investigation. Kidney graft rejection rates graft-survival rates appear to be similar to those in HIV-uninfected populations. A large multicenter study of the safety and efficacy of kidney and liver transplantation in HIV-infected patients is under way. Findings from this study should help to provide guidance in achieving optimal outcomes in this population. This article summarizes a presentation by Michelle E. Roland, MD, at the February and April 2004 International AIDS Society-USA courses in Atlanta, Los Angeles, and Chicago.