Long-term outcomes of orthotopic liver transplantation in human immunodeficiency virus-infected patients and comparison with human immunodeficiency virus-negative cases

U. Baccarani, G. L. Adani, F. Bragantini, A. Londero, C. Comuzzi, A. Rossetto, D. Lorenzin, V. Bresadola, A. Risaliti, F. Pea, P. Toniutto, A. Donini, D. De Anna, F. Bresadola, M. Tavio, P. Viale

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Abstract

Human immunodeficiency virus (HIV) positivity is no longer a contraindication for orthotopic liver transplantation (OLT) due to the efficacy of antiretroviral therapy. The aim of this study was to compare OLT among HIV-positive and HIV-negative cohorts; the results were also stratified for hepatitis C virus (HCV) coinfection. Between 2004 and 2009, all HIV-infected patients undergoing OLT from heart-beating deceased donors (n = 27) were compared with an HIV-negative cohort (n = 27). The pure HCV infection rate was similar between HIV-positive and HIV-negative subjects (63% each). HIV-positive recipients were younger (P = .013). The CD4 count for HIV-positive subjects was 376 ± 156 at transplantation. The mean model for end-stage liver disease (MELD) score at transplantation was 15 ± 7 in both groups (P = .92). No differences were observed for donor age (P = .72) or time on the waiting list (P = .56). The median follow-up was 26 (range, 1-64) and 27 months (range, 1-48) for HIV and non-HIV recipients, respectively (P = .85). The estimated 1-, 3-, and 5-year patient and graft survival rates were 88%, 83%, and 83% versus 100%, 73%, and 73% (P = .95), and 92%, 87%, and 87% versus 95%, 88%, and 88% (P = .59) for HIV and non-HIV cases, respectively. HIV/HCV-coinfected patients were younger, namely 47 (range, 40-53) versus 52 years (range, 37-68; P = .003), and displayed lower MELD scores at transplantation compared with HCV-mono-infected patients 10 (range, 7-19) versus 17 (range, 8-30) (P = .008). For HIV/HCV-coinfected and HCV-mono-infected cases the estimated 1-, 3-, and 5-year patients and graft survival rates were respectively 93%, 76%, and 76% versus 100%, 70%, and 60% (P = .99) and 93%, 84%, and 84% versus 100%, 70%, and 60% (P = .64), respectively. No difference was observed in the histological severity of HCV recurrence. In conclusion, under specific, well-determined conditions, OLT can be a safe, efficacious procedure in HIV patients.

Original languageEnglish
Pages (from-to)1119-1122
Number of pages4
JournalTransplantation Proceedings
Volume43
Issue number4
DOIs
Publication statusPublished - May 2011

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Liver Transplantation
HIV
Hepacivirus
End Stage Liver Disease
Transplantation
Graft Survival
Survival Rate
Tissue Donors
Viruses
Waiting Lists
Virus Diseases
CD4 Lymphocyte Count
Coinfection
HIV-1
Recurrence

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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Long-term outcomes of orthotopic liver transplantation in human immunodeficiency virus-infected patients and comparison with human immunodeficiency virus-negative cases. / Baccarani, U.; Adani, G. L.; Bragantini, F.; Londero, A.; Comuzzi, C.; Rossetto, A.; Lorenzin, D.; Bresadola, V.; Risaliti, A.; Pea, F.; Toniutto, P.; Donini, A.; De Anna, D.; Bresadola, F.; Tavio, M.; Viale, P.

In: Transplantation Proceedings, Vol. 43, No. 4, 05.2011, p. 1119-1122.

Research output: Contribution to journalArticle

Baccarani, U, Adani, GL, Bragantini, F, Londero, A, Comuzzi, C, Rossetto, A, Lorenzin, D, Bresadola, V, Risaliti, A, Pea, F, Toniutto, P, Donini, A, De Anna, D, Bresadola, F, Tavio, M & Viale, P 2011, 'Long-term outcomes of orthotopic liver transplantation in human immunodeficiency virus-infected patients and comparison with human immunodeficiency virus-negative cases', Transplantation Proceedings, vol. 43, no. 4, pp. 1119-1122. https://doi.org/10.1016/j.transproceed.2011.01.124
Baccarani, U. ; Adani, G. L. ; Bragantini, F. ; Londero, A. ; Comuzzi, C. ; Rossetto, A. ; Lorenzin, D. ; Bresadola, V. ; Risaliti, A. ; Pea, F. ; Toniutto, P. ; Donini, A. ; De Anna, D. ; Bresadola, F. ; Tavio, M. ; Viale, P. / Long-term outcomes of orthotopic liver transplantation in human immunodeficiency virus-infected patients and comparison with human immunodeficiency virus-negative cases. In: Transplantation Proceedings. 2011 ; Vol. 43, No. 4. pp. 1119-1122.
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abstract = "Human immunodeficiency virus (HIV) positivity is no longer a contraindication for orthotopic liver transplantation (OLT) due to the efficacy of antiretroviral therapy. The aim of this study was to compare OLT among HIV-positive and HIV-negative cohorts; the results were also stratified for hepatitis C virus (HCV) coinfection. Between 2004 and 2009, all HIV-infected patients undergoing OLT from heart-beating deceased donors (n = 27) were compared with an HIV-negative cohort (n = 27). The pure HCV infection rate was similar between HIV-positive and HIV-negative subjects (63{\%} each). HIV-positive recipients were younger (P = .013). The CD4 count for HIV-positive subjects was 376 ± 156 at transplantation. The mean model for end-stage liver disease (MELD) score at transplantation was 15 ± 7 in both groups (P = .92). No differences were observed for donor age (P = .72) or time on the waiting list (P = .56). The median follow-up was 26 (range, 1-64) and 27 months (range, 1-48) for HIV and non-HIV recipients, respectively (P = .85). The estimated 1-, 3-, and 5-year patient and graft survival rates were 88{\%}, 83{\%}, and 83{\%} versus 100{\%}, 73{\%}, and 73{\%} (P = .95), and 92{\%}, 87{\%}, and 87{\%} versus 95{\%}, 88{\%}, and 88{\%} (P = .59) for HIV and non-HIV cases, respectively. HIV/HCV-coinfected patients were younger, namely 47 (range, 40-53) versus 52 years (range, 37-68; P = .003), and displayed lower MELD scores at transplantation compared with HCV-mono-infected patients 10 (range, 7-19) versus 17 (range, 8-30) (P = .008). For HIV/HCV-coinfected and HCV-mono-infected cases the estimated 1-, 3-, and 5-year patients and graft survival rates were respectively 93{\%}, 76{\%}, and 76{\%} versus 100{\%}, 70{\%}, and 60{\%} (P = .99) and 93{\%}, 84{\%}, and 84{\%} versus 100{\%}, 70{\%}, and 60{\%} (P = .64), respectively. No difference was observed in the histological severity of HCV recurrence. In conclusion, under specific, well-determined conditions, OLT can be a safe, efficacious procedure in HIV patients.",
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AU - Londero, A.

AU - Comuzzi, C.

AU - Rossetto, A.

AU - Lorenzin, D.

AU - Bresadola, V.

AU - Risaliti, A.

AU - Pea, F.

AU - Toniutto, P.

AU - Donini, A.

AU - De Anna, D.

AU - Bresadola, F.

AU - Tavio, M.

AU - Viale, P.

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N2 - Human immunodeficiency virus (HIV) positivity is no longer a contraindication for orthotopic liver transplantation (OLT) due to the efficacy of antiretroviral therapy. The aim of this study was to compare OLT among HIV-positive and HIV-negative cohorts; the results were also stratified for hepatitis C virus (HCV) coinfection. Between 2004 and 2009, all HIV-infected patients undergoing OLT from heart-beating deceased donors (n = 27) were compared with an HIV-negative cohort (n = 27). The pure HCV infection rate was similar between HIV-positive and HIV-negative subjects (63% each). HIV-positive recipients were younger (P = .013). The CD4 count for HIV-positive subjects was 376 ± 156 at transplantation. The mean model for end-stage liver disease (MELD) score at transplantation was 15 ± 7 in both groups (P = .92). No differences were observed for donor age (P = .72) or time on the waiting list (P = .56). The median follow-up was 26 (range, 1-64) and 27 months (range, 1-48) for HIV and non-HIV recipients, respectively (P = .85). The estimated 1-, 3-, and 5-year patient and graft survival rates were 88%, 83%, and 83% versus 100%, 73%, and 73% (P = .95), and 92%, 87%, and 87% versus 95%, 88%, and 88% (P = .59) for HIV and non-HIV cases, respectively. HIV/HCV-coinfected patients were younger, namely 47 (range, 40-53) versus 52 years (range, 37-68; P = .003), and displayed lower MELD scores at transplantation compared with HCV-mono-infected patients 10 (range, 7-19) versus 17 (range, 8-30) (P = .008). For HIV/HCV-coinfected and HCV-mono-infected cases the estimated 1-, 3-, and 5-year patients and graft survival rates were respectively 93%, 76%, and 76% versus 100%, 70%, and 60% (P = .99) and 93%, 84%, and 84% versus 100%, 70%, and 60% (P = .64), respectively. No difference was observed in the histological severity of HCV recurrence. In conclusion, under specific, well-determined conditions, OLT can be a safe, efficacious procedure in HIV patients.

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