Update on kidney transplantation in human immunodeficiency virus infected recipients

Nashar, Khaled; Sureshkumar, Kalathil K

doi:10.5527/wjn.v5.i4.300

Cited by 4 publications

(2 citation statements)

References 53 publications

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“…This has been shown to be difficult while the patient is using other interacting antiretroviral agents. 7 Increased incidence of DGF, which is defined as the need for dialysis after transplant, has been reported for HIV-positive patients, even with living donor transplants. Stock and associates reported DGF in 15% of living donor recipients and in 46% of deceased donor recipients.…”

Section: Discussionmentioning

confidence: 99%

Kidney Transplant in a Human Immunodeficiency Virus-Positive Patient: Case Report of Drug Interactions

Yılmaz¹,

Gökengin²,

Bozbıyık³

et al. 2023

Exp Clin Transplant

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End-stage renal disease in the human immunodeficiency virus-positive population is increasing. Kidney transplant is the optimal therapy for this population rather than dialysis modalities if some criteria are met. These include undetectable plasma human immunodeficiency virus RNA, CD4 cell count over 200 cells/µL, and the absence of any AIDS-defining illness. Here, we describe the first living-donor kidney transplant in a human immunodeficiency virus-positive recipient in Turkey. The patient, a 52-year-old male diagnosed as human immunodeficiency virus positive, was on antiretroviral therapy, which consisted of 400 mg twice daily darunavir, 100 mg/day ritonavir, and 50 mg/day dolutegravir. He had been negative for human immunodeficiency virus RNA for the past 3 years. The patient developed renal insufficiency without any known cause and started hemodialysis. A living donor transplant from his son was performed, and the patient received ATG Fresenius-S (Neovii Biotech, Rapperswil, Switzerland) induction and a maintenance immunosuppression therapy consisting of methylprednisolone, mycophenolate mofetil, and tacrolimus. There were no incidences of delayed graft function or acute rejection. Because of tacrolimus and ritonavir interaction, tacrolimus trough levels were too high. With tacrolimus withdrawn, tacrolimus trough level decreased to detectable levels 2 weeks later. Antiretroviral therapy was continued on the same dosage. At month 4 posttransplant, the patient's creatinine level was 1.01 mg/dL. At present, the patient has had no complications and no episodes of rejection. Kidney transplant is the most favorable replacement therapy for HIV-positive patients who are under controlled AIDS care with highly active antiretroviral therapy. However, drug interactions should be carefully evaluated. Key words: HIV infection, Immunosuppression, Renal transplantation IntroductionThe introduction of highly active antiretroviral therapy has reduced the mortality and progression to acquired immunodeficiency syndrome (AIDS). However, end-stage renal disease can occur in patients who are human immunodeficiency virus (HIV) positive. A broad spectrum of diseases such as hypertension, diabetes mellitus, and glomerular diseases are the major causes of end-stage kidney disease. 1 Human immunodeficiency virus-associated nephropathy is a specific glomerular collapsing sclerosing disease seen in HIV-positive patients. 2 Whatever the cause, renal transplant is the optimal therapy for the HIV-positive population rather than dialysis modalities if some criteria are met. These criteria include undetectable plasma HIV RNA, CD4 cell count over 200 cells/μL, and the absence of any AIDS-defining illnesses. 3 Over time, the best immunosuppression modalities have become better known for this population of patients. However, drug interactions are still important points with immunosuppression therapy. Delayed graft function (DGF) and acute rejection are the most important issues to be noted carefully during the early posttransplant perio...

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Section: Discussionmentioning

confidence: 99%

Kidney Transplant in a Human Immunodeficiency Virus-Positive Patient: Case Report of Drug Interactions

Yılmaz¹,

Gökengin²,

Bozbıyık³

et al. 2023

Exp Clin Transplant

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“…

Solid organ transplantation is increasingly used in human immunodeficiency virus (HIV) patients and is accumulating favorable outcomes from kidney and liver transplants in HIV-1 positive patients. 1,2 Antithymocyte globulin (ATG) is used for prevention and treatment of acute rejection following renal transplantation. 3 It promotes T-cell depletion as well as modulation of cell surface antigens.

…”

mentioning

confidence: 99%

Transient Loss of HIV-1 DNA in an HIV-1 Positive Patient After Kidney Transplantation: A Case Report

Paim

Rizza

Badley

et al. 2018

The American Journal of Medicine

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Effectiveness of kidney transplantation in HIV-infected recipients under combination antiretroviral therapy: a single-cohort experience (Brescia, Northern Italy)

et al. 2017

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Kidney transplantation appears to be safe in HIV-infected patients carefully selected. As previously reported, we observed a high incidence of acute rejection. We expect that the recent implementation of the immunosuppressive protocols will allow a better immunologic control. Moreover, the introduction of InSTI permits a better strategy of cART, with lower incidence of PK interactions with immunosuppressive drugs.

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Update on kidney transplantation in human immunodeficiency virus infected recipients

Abstract: Improved survival of human immunodeficiency virus

Cited by 4 publications

References 53 publications

Kidney Transplant in a Human Immunodeficiency Virus-Positive Patient: Case Report of Drug Interactions

Kidney Transplant in a Human Immunodeficiency Virus-Positive Patient: Case Report of Drug Interactions

Transient Loss of HIV-1 DNA in an HIV-1 Positive Patient After Kidney Transplantation: A Case Report

Effectiveness of kidney transplantation in HIV-infected recipients under combination antiretroviral therapy: a single-cohort experience (Brescia, Northern Italy)

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