Hayes Kellen, Van Sickels Nicholas, Buell Joseph, Killackey Mary, Zhang Rubin, Slakey Douglas, Lukitsch Ivo, Alper Arnold, Mushatt David, Asad Shadaba, Paramesh Anil
Tulane University School of Medicine, USA.
J La State Med Soc. 2012 Jul-Aug;164(4):191-3.
Human immunodeficiency virus (HIV) seropositivity has historically been an absolute contraindication for solid organ transplantation. However, the successful application of HAART (highly active anti-retroviral therapy) drug regimens has greatly prolonged the life expectancy of HIV-positive patients. Therefore, it has become appropriate to consider this patient population for transplantation. HIV positive transplants are being performed around the country in controlled settings, usually as part of a research protocol. The aim of our study is to describe the Louisiana experience with organ transplantation into HIV-positive patients. We identified seven HIV-positive patients who underwent kidney or kidney/pancreas transplantation at our center between 2007 and 2010. We performed a retrospective chart review to ascertain graft function, as well as virologic and immunologic status post-transplant. Renal function (glomerular filtration rate and serum creatinine concentrations) improved in all subjects post-transplant, and six of seven (85.8%) subjects remained virologically suppressed with no progression to Acquired Immunodeficiency Syndrome (AIDS). Overall, two-year graft and patient survival rates were 85.5%. HIV seropositive End Stage Renal Disease (ESRD) patients represent a new population of patients that can be successfully transplanted. This offers a new dimension in care for successful HAART therapy to prolong the life of HIV-infected patients.
从历史上看,人类免疫缺陷病毒(HIV)血清反应阳性一直是实体器官移植的绝对禁忌证。然而,高效抗逆转录病毒疗法(HAART)药物方案的成功应用极大地延长了HIV阳性患者的预期寿命。因此,考虑将这一患者群体纳入移植对象变得可行。目前全国各地都在可控的环境下为HIV阳性患者进行移植手术,通常作为研究方案的一部分。我们研究的目的是描述路易斯安那州在为HIV阳性患者进行器官移植方面的经验。我们确定了2007年至2010年间在我们中心接受肾脏或肾脏/胰腺移植的7名HIV阳性患者。我们进行了回顾性病历审查,以确定移植后的移植物功能以及病毒学和免疫学状况。所有受试者移植后的肾功能(肾小球滤过率和血清肌酐浓度)均有所改善,7名受试者中有6名(85.8%)病毒学得到抑制,未进展为获得性免疫缺陷综合征(AIDS)。总体而言,两年的移植物和患者生存率为85.5%。HIV血清反应阳性的终末期肾病(ESRD)患者代表了一类能够成功接受移植的新患者群体。这为通过成功的HAART疗法延长HIV感染患者的生命提供了新的护理层面。