Bharadwaj Rashmi R, Orozco Gabriel, Mei Xiaonan, El-Haddad Hanine, Gedaly Roberto, Gupta Meera
University of Kentucky College of Medicine, Lexington, Kentucky, USA.
Department of Surgery, University of Kentucky Transplant Center, University of Kentucky Healthcare, Lexington, Kentucky, USA.
Am J Transplant. 2025 Apr;25(4):836-847. doi: 10.1016/j.ajt.2024.11.023. Epub 2024 Nov 29.
There is limited information on access and outcomes of patients living with human immunodeficiency virus (HIV) (PLWH) who have undergone pancreas transplantation. We conducted a retrospective cohort study analyzing data from the United Network for Organ Sharing from July 1, 2001, to June 30, 2021. Recipients of pancreas transplant were stratified by HIV serostatus. Graft and patient survival were analyzed using Kaplan-Meier product limit estimates. Multivariable Cox proportional hazard models were generated to identify factors associated with increased mortality or graft loss. Fifty PLWH and 16 380 patients without HIV underwent pancreas (with kidney) transplantation. PLWH were more often male (P < .001), Black/African American (P = .009), and on Medicare (P = .004). There were no significant differences in waiting time (P = .159) or proportion of patients treated for rejection within 1 year of transplant (P = .189) between groups. There were no differences in pancreas graft survival (P = .964) and overall patient survival (P = .250) between the cohorts. Dialysis status was negatively associated with graft survival. Although PLWH were more likely to represent a historically marginalized population, their outcomes after pancreas transplant were similar to their HIV-negative counterparts.
关于接受胰腺移植的人类免疫缺陷病毒（HIV）感染者（PLWH）的就医机会和治疗结果的信息有限。我们进行了一项回顾性队列研究，分析了2001年7月1日至2021年6月30日器官共享联合网络的数据。胰腺移植受者按HIV血清学状态分层。使用Kaplan-Meier乘积限估计法分析移植物和患者的生存率。生成多变量Cox比例风险模型，以确定与死亡率增加或移植物丢失相关的因素。50名PLWH和16380名未感染HIV的患者接受了胰腺（联合肾脏）移植。PLWH更常见于男性（P <.001）、黑人/非裔美国人（P =.009），且参加医疗保险（P =.004）。两组之间的等待时间（P =.159）或移植后1年内接受抗排斥治疗的患者比例（P =.189）没有显著差异。队列之间的胰腺移植物存活率（P =.964）和患者总体存活率（P =.250）没有差异。透析状态与移植物存活率呈负相关。虽然PLWH更有可能代表一个历史上被边缘化的人群，但他们胰腺移植后的结果与未感染HIV的患者相似。
