Sawinski Deirdre
Department of Medicine, Renal Electrolyte and Hypertension Division, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104.
Transplant Rev (Orlando). 2017 Jan;31(1):42-46. doi: 10.1016/j.trre.2016.10.003. Epub 2016 Oct 11.
HIV+ patients are at increased risk for end-stage renal disease, but HIV infection was once considered a contraindication to renal transplantation. However, contemporary studies from the United States and Europe have now demonstrated that renal transplantation is a safe and effective treatment for end-stage renal disease in HIV patients, with equivalent patient and allograft survival to those uninfected. Broader experience in transplantation in HIV+ patients has identified unique challenges including high rates of acute rejection, delayed graft function, and significant drug-drug interactions. Kidney transplantation in HIV-infected patients is an active area of clinical research and trials of HIV+ to HIV+ transplantation in the United States are underway.
HIV阳性患者患终末期肾病的风险增加,但HIV感染曾一度被视为肾移植的禁忌证。然而,美国和欧洲的当代研究现已表明,肾移植对于HIV患者的终末期肾病是一种安全有效的治疗方法,患者和移植肾的存活率与未感染者相当。对HIV阳性患者移植的更多经验已发现了一些独特的挑战,包括急性排斥反应发生率高、移植肾功能延迟恢复以及显著的药物相互作用。HIV感染患者的肾移植是临床研究的一个活跃领域,美国正在进行HIV阳性患者之间的肾移植试验。