Liver retransplantation in HIV-infected patients: a prospective cohort study

Am J Transplant. 2012 Sep;12(9):2465-76. doi: 10.1111/j.1600-6143.2012.04142.x. Epub 2012 Jun 15.

Abstract

Information regarding liver retransplantation in HIV-infected patients is scant. Data from 14 HIV-infected patients retransplanted between 2002 and 2011 in Spain (6% retransplantation rate) were analyzed and compared with those from 157 matched HIV-negative retransplanted patients. In HIV-infected patients, early (≤30 days) retransplantation was more frequently indicated (57% vs. 29%; p = 0.057), and retransplantation for HCV recurrence was less frequently indicated (7% vs. 37%; p = 0.036). Survival probability after retransplantation in HIV-positive patients was lower than in HIV-negative patients, 42% versus 64% at 3 years, although not significantly (p = 0.160). Among HIV-infected patients, those with undetectable HCV RNA at retransplantation and those with late (>30 days) retransplantation showed better 3-year survival probability (80% and 67%, respectively), similar to that in their respective HIV-negative counterparts (72% and 70%). In HIV-infected and HIV-negative patients, 3-year survival probability in those with positive HCV RNA at retransplantation was 22% versus 65% (p = 0.008); in those with early retransplantation, 3-year survival probability was 25% versus 56% (p = 0.282). HIV infection was controlled with antiretroviral therapy after retransplantation. In conclusion, HIV-infected patients taken as a whole have unsatisfactory survival after liver retransplantation, although patients with undetectable HCV RNA at retransplantation or undergoing late retransplantation show a more favorable outcome.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • HIV Infections / complications
  • HIV Infections / surgery*
  • Hepacivirus / genetics
  • Hepacivirus / isolation & purification
  • Hepatitis C / complications
  • Hepatitis C / surgery*
  • Humans
  • Liver Transplantation*
  • Male
  • Middle Aged
  • Prospective Studies
  • RNA, Viral / isolation & purification
  • Reoperation*
  • Survival Analysis

Substances

  • RNA, Viral