Mayer Cynthia, Agbobli-Nuwoaty Selom Enyo, Li Jun, Carlson Kimberly, Palella Frank J, Durham Marcus D, Buchacz Kate
St. Joseph's Hospital Comprehensive Research Institute, Tampa, FL.
Cerner Corporation, Kansas City, MO.
J Acquir Immune Defic Syndr. 2024 Dec 1;97(4):397-401. doi: 10.1097/QAI.0000000000003503.
Persons with HIV (PWH) with end-stage kidney disease (ESKD) who are eligible for kidney transplantation have post-transplantation outcomes similar to those without HIV infection. However, barriers to referral for care, evaluation, and receipt of transplants remain for PWH. We sought to identify PWH with ESKD or end-stage liver disease (ESLD) who would be candidates for organ transplant and to review their clinical outcomes.
We analyzed data from participants in the HIV Outpatient Study (HOPS) between January 1, 2009, and June 30, 2023, with a diagnosis of ESKD or ESLD. We identified a subset of PWH who would otherwise meet the general criteria for kidney or liver transplantation. Targeted clinical outcomes included dialysis, transplantation, and death.
Among 5215 PWH in the HOPS, 258 with ESKD and 23 with ESLD would otherwise meet the criteria for transplant. However, only 9 kidney and 2 liver transplants were performed.
Low transplantation rates among eligible PWH suggest that timely referral for care and evaluation for kidney and liver transplantation often does not occur. Expanding access for PWH with ESKD to both deceased and living donor kidney allografts is needed. Kidney and liver transplant centers also need to seek ways to broaden access for eligible PWH with ESKD or ESLD.
符合肾移植条件的晚期肾病（ESKD）的艾滋病毒感染者（PWH）移植后的预后与未感染艾滋病毒者相似。然而，PWH在转诊接受治疗、评估和移植方面仍然存在障碍。我们试图确定患有ESKD或晚期肝病（ESLD）且可能成为器官移植候选人的PWH，并回顾他们的临床结局。
我们分析了2009年1月1日至2023年6月30日期间参加艾滋病毒门诊研究（HOPS）且诊断为ESKD或ESLD的参与者的数据。我们确定了一部分原本符合肾或肝移植一般标准的PWH。目标临床结局包括透析、移植和死亡。
在HOPS的5215名PWH中，258名患有ESKD，23名患有ESLD，他们原本符合移植标准。然而，仅进行了9例肾移植和2例肝移植。
符合条件的PWH移植率较低，这表明肾和肝移植的及时转诊接受治疗和评估往往没有实现。需要扩大患有ESKD的PWH获得死者和活体供肾同种异体移植物的机会。肾和肝移植中心还需要寻求方法，为符合条件的患有ESKD或ESLD的PWH拓宽途径。
