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HOPE in action: A prospective multicenter pilot study of liver transplantation from donors with HIV to recipients with HIV.
Durand, Christine M; Florman, Sander; Motter, Jennifer D; Brown, Diane; Ostrander, Darin; Yu, Sile; Liang, Tao; Werbel, William A; Cameron, Andrew; Ottmann, Shane; Hamilton, James P; Redd, Andrew D; Bowring, Mary G; Eby, Yolanda; Fernandez, Reinaldo E; Doby, Brianna; Labo, Nazzarena; Whitby, Denise; Miley, Wendell; Friedman-Moraco, Rachel; Turgeon, Nicole; Price, Jennifer C; Chin-Hong, Peter; Stock, Peter; Stosor, Valentina; Kirchner, Varvara A; Pruett, Timothy; Wojciechowski, David; Elias, Nahel; Wolfe, Cameron; Quinn, Thomas C; Odim, Jonah; Morsheimer, Megan; Mehta, Sapna A; Rana, Meenakshi M; Huprikar, Shirish; Massie, Allan; Tobian, Aaron A R; Segev, Dorry L.
Afiliación
  • Durand CM; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Florman S; Recanati-Miller Transplantation Institute, The Mount Sinai Hospital, New York, New York.
  • Motter JD; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Brown D; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Ostrander D; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Yu S; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Liang T; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Werbel WA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Cameron A; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Ottmann S; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Hamilton JP; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Redd AD; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Bowring MG; Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
  • Eby Y; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Fernandez RE; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Doby B; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Labo N; Phoenix, Arizona.
  • Whitby D; Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland.
  • Miley W; Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland.
  • Friedman-Moraco R; Viral Oncology Section, AIDS and Cancer Virus Program, Frederick National Laboratory for Cancer Research, Frederick, Maryland.
  • Turgeon N; Department of Medicine, Emory University, Atlanta, Georgia.
  • Price JC; Department of Medicine, Emory University, Atlanta, Georgia.
  • Chin-Hong P; Department of Medicine, University of California, San Francisco, California.
  • Stock P; Department of Medicine, University of California, San Francisco, California.
  • Stosor V; Department of Medicine, University of California, San Francisco, California.
  • Kirchner VA; Divisions of Infectious Diseases and Organ Transplantation Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
  • Pruett T; University of Minnesota, Minneapolis, Minnesota.
  • Wojciechowski D; University of Minnesota, Minneapolis, Minnesota.
  • Elias N; Massachusetts General Hospital, Boston, Massachusetts.
  • Wolfe C; Massachusetts General Hospital, Boston, Massachusetts.
  • Quinn TC; Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina.
  • Odim J; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Morsheimer M; Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
  • Mehta SA; Division of Allergy, Immunology and Transplantation, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
  • Rana MM; Division of Allergy, Immunology and Transplantation, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
  • Huprikar S; New York University Langone Transplant Institute, New York, New York.
  • Massie A; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
  • Tobian AAR; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
  • Segev DL; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Am J Transplant ; 22(3): 853-864, 2022 03.
Article en En | MEDLINE | ID: mdl-34741800
Liver transplantation (LT) from donors-with-HIV to recipients-with-HIV (HIV D+/R+) is permitted under the HOPE Act. There are only three international single-case reports of HIV D+/R+ LT, each with limited follow-up. We performed a prospective multicenter pilot study comparing HIV D+/R+ to donors-without-HIV to recipients-with-HIV (HIV D-/R+) LT. We quantified patient survival, graft survival, rejection, serious adverse events (SAEs), human immunodeficiency virus (HIV) breakthrough, infections, and malignancies, using Cox and negative binomial regression with inverse probability of treatment weighting. Between March 2016-July 2019, there were 45 LTs (8 simultaneous liver-kidney) at 9 centers: 24 HIV D+/R+, 21 HIV D-/R+ (10 D- were false-positive). The median follow-up time was 23 months. Median recipient CD4 was 287 cells/µL with 100% on antiretroviral therapy; 56% were hepatitis C virus (HCV)-seropositive, 13% HCV-viremic. Weighted 1-year survival was 83.3% versus 100.0% in D+ versus D- groups (p = .04). There were no differences in one-year graft survival (96.0% vs. 100.0%), rejection (10.8% vs. 18.2%), HIV breakthrough (8% vs. 10%), or SAEs (all p > .05). HIV D+/R+ had more opportunistic infections, infectious hospitalizations, and cancer. In this multicenter pilot study of HIV D+/R+ LT, patient and graft survival were better than historical cohorts, however, a potential increase in infections and cancer merits further investigation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Trasplante de Hígado / Hepatitis C Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Trasplante de Hígado / Hepatitis C Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos