Liver transplantation in HIV-positive patients: the position of the Brazilian groups

Brandão, Ajácio; Mariante-Neto, Guilherme

doi:10.1590/s0004-28032005000300007

Cited by 6 publications

(2 citation statements)

References 35 publications

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“…Recent reports of organ transplantation in HIV‐infected patients are encouraging, with similar results of patient and graft survival as compared with non‐HIV‐infected patients. However, in certain countries, some centres still do not accept HIV‐infected patients on their transplant waiting lists [80]. Nevertheless, in the majority of countries, solid‐organ transplantation in HIV‐infected patients has been initiated, but the series and clinical studies generally remain limited and the follow‐up is relatively short.…”

Section: Discussionmentioning

confidence: 99%

Effects of immunosuppressive drugs on HIV infection: implications for solid-organ transplantation

2007

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Summary With the advent of highly active antiretroviral therapy (HAART), HIV infection has become a chronic disease. Various end‐stage organ failures have now become common co‐morbidities and are primary causes of mortality in HIV‐infected patients. Solid‐organ transplantation therefore has been proposed to these patients, as HIV infection is not anymore considered an absolute contraindication. The initial results of organ transplantation in HIV‐infected patients are encouraging with no differences in patient and graft survival compared with non‐HIV‐infected patients. The use of immunosuppressive drug therapy in HIV‐infected patients has so far not shown major detrimental effects, and some drugs in combination with HAART have even demonstrated possible beneficial effects for specific HIV settings. Nevertheless, organ transplantation in HIV‐infected patients remains a complex intervention, and more studies will be required to clarify open questions such as long‐term effects of drug interactions between antiretroviral and immunosuppressive drugs, outcome of recurrent HCV infection in HIV‐infected patients, incidence of graft rejection, or long‐term graft and patient survival. In this article, we first review the immunological pathogenesis of HIV infection and the rationale for using immunosuppression combined with HAART. We then discuss the most recent results of solid‐organ transplantation in HIV‐infected patients.

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Section: Discussionmentioning

confidence: 99%

Effects of immunosuppressive drugs on HIV infection: implications for solid-organ transplantation

2007

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“…The authors have correlated overexpression of vascular endothelial growth factor and alpha fetoprotein in liver tissue of subjects with HCC, particularly in those with advanced stages according to BCLC classification. Until recently (16) few Brazilian centers were accepting HIV+ patients for LT due to stigma and fear of adverse postoperative outcomes. Hyppolito et al (17) have described the follow-up of HIV+ subjects after LT with outcomes very similar to those reported in patients without HIV, supporting the widespread notion that HIV status per se should not withhold LT whenever indicated.…”

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confidence: 99%