Alfano Gaetano, Mori Giacomo, Fontana Francesco, Dolci Giovanni, Baisi Alberto, Ligabue Giulia, Ferrari Annachiara, Solazzo Andrea, Franceschini Erica, Guaradi Giovanni, Mussini Cristina, Cappelli Gianni
1 Nephrology Dialysis and Transplant Unit, University of Modena and Reggio Emilia, AOU Policlinico of Modena, Modena, Italy.
2 Clinic of Infectious Diseases, University of Modena and Reggio Emilia, AOU Policlinico of Modena, Modena, Italy.
Int J STD AIDS. 2018 Nov;29(13):1305-1315. doi: 10.1177/0956462418779659. Epub 2018 Jul 10.
Kidney transplantation is a safe and effective option for HIV-positive (HIV) patients. We conducted a retrospective study on HIV kidney transplant recipients who underwent transplantation from March 2008 to September 2016. Inclusion criteria for transplantation were CD4+ T-cell count ≥200 per mm and undetectable HIV load. The current study reports the outcome of 19 HIV recipients, mostly of Caucasian origin (79%) with a median age of 50 years (interquartile range [IQR], 42-52), who were followed up for a median period of 2.4 years (IQR, 1.2-4.6) after transplantation. Compared with HIV-negative (HIV) controls, HIV recipients had similar one- and three-year graft and patient survival, but significantly lower five-year patient survival (P = 0.03). The differences in graft outcome became less evident with the analysis of death-censored graft survival rates. Cumulative incidence of allograft rejection at one year was 32.9%. Rates of infections were not particularly elevated and HIV replication remained well controlled in all but one patient. A high prevalence of metabolic and endocrine complications (68%) was reported after transplantation. Further studies are needed to evaluate long-term outcomes of HIV recipients who underwent kidney transplantation.
肾移植对于HIV阳性患者来说是一种安全有效的选择。我们对2008年3月至2016年9月期间接受移植的HIV肾移植受者进行了一项回顾性研究。移植的纳入标准是CD4 + T细胞计数≥200/mm且HIV病毒载量检测不到。本研究报告了19名HIV受者的结局，这些受者大多为白种人（79%），中位年龄为50岁（四分位间距[IQR]，42 - 52岁），移植后中位随访时间为2.4年（IQR，1.2 - 4.6年）。与HIV阴性对照相比，HIV受者的1年和3年移植物及患者生存率相似，但5年患者生存率显著较低（P = 0.03）。通过对死亡校正的移植物生存率分析，移植物结局的差异变得不那么明显。1年时同种异体移植排斥的累积发生率为32.9%。感染率没有特别升高，除1名患者外，所有患者的HIV复制均得到良好控制。移植后报告了高发生率的代谢和内分泌并发症（68%）。需要进一步研究来评估接受肾移植的HIV受者的长期结局。
