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Renal transplantation in human immunodeficiency virus-infected recipients: a case-control study from the Brazilian experience.
Vicari, A R; Spuldaro, F; Sandes-Freitas, T V; Cristelli, M P; Requião-Moura, L R; Reusing, J O; Pierrotti, L C; Oliveira, M L; Girão, C M; Gadonski, G; Kroth, L V; Deboni, L M; Ferreira, G F; Tedesco-Silva, H; Esmeraldo, R; David-Neto, E; Saitovitch, D; Keitel, E; Garcia, V D; Pacheco-Silva, A; Medina-Pestana, J O; Manfro, R C.
Afiliação
  • Vicari AR; Renal Transplant Unit, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
  • Spuldaro F; Renal Transplant Unit, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
  • Sandes-Freitas TV; Hospital do Rim, Federal University of São Paulo, São Paulo, SP, Brazil.
  • Cristelli MP; Hospital do Rim, Federal University of São Paulo, São Paulo, SP, Brazil.
  • Requião-Moura LR; Renal Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  • Reusing JO; Renal Transplant Unit, Hospital das Clínicas de São Paulo, University of São Paulo, São Paulo, SP, Brazil.
  • Pierrotti LC; Renal Transplant Unit, Hospital das Clínicas de São Paulo, University of São Paulo, São Paulo, SP, Brazil.
  • Oliveira ML; Renal Transplant Unit, Hospital Geral de Fortaleza, Fortaleza, CE, Brazil.
  • Girão CM; Renal Transplant Unit, Hospital Geral de Fortaleza, Fortaleza, CE, Brazil.
  • Gadonski G; Renal Transplant Unit, Hospital São Lucas, Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
  • Kroth LV; Renal Transplant Unit, Hospital São Lucas, Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
  • Deboni LM; Hospital Municipal São José e Fundação Pró-Rim, Joinville, SC, Brazil.
  • Ferreira GF; Hospital Santa Casa de Misericórdia de Juiz de Fora, Juiz de Fora, MG, Brazil.
  • Tedesco-Silva H; Hospital do Rim, Federal University of São Paulo, São Paulo, SP, Brazil.
  • Esmeraldo R; Renal Transplant Unit, Hospital Geral de Fortaleza, Fortaleza, CE, Brazil.
  • David-Neto E; Renal Transplant Unit, Hospital das Clínicas de São Paulo, University of São Paulo, São Paulo, SP, Brazil.
  • Saitovitch D; Renal Transplant Unit, Hospital São Lucas, Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
  • Keitel E; Renal Transplant Unit, Hospital Santa Casa de Porto Alegre, Federal University of Medical Sciences of Porto Alegre, Porto Alegre, RS, Brazil.
  • Garcia VD; Renal Transplant Unit, Hospital Santa Casa de Porto Alegre, Federal University of Medical Sciences of Porto Alegre, Porto Alegre, RS, Brazil.
  • Pacheco-Silva A; Renal Transplant Unit, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  • Medina-Pestana JO; Hospital do Rim, Federal University of São Paulo, São Paulo, SP, Brazil.
  • Manfro RC; Renal Transplant Unit, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil. rmanfro@hcpa.edu.br.
Transpl Infect Dis ; 18(5): 730-740, 2016 Oct.
Article em En | MEDLINE | ID: mdl-27503081
BACKGROUND: Highly active antiretroviral therapy has turned human immunodeficiency virus (HIV)-infected patients with end-stage renal disease into suitable candidates for renal transplantation. We present the Brazilian experience with kidney transplantation in HIV-infected recipients observed in a multicenter study. METHODS: HIV-infected kidney transplant recipients and matched controls were evaluated for the incidence of delayed graft function (DGF), acute rejection (AR), infections, graft function, and survival of patients and renal grafts. RESULTS: Fifty-three HIV-infected recipients and 106 controls were enrolled. Baseline characteristics were similar, but a higher frequency of pre-transplant positivity for hepatitis C virus and cytomegalovirus infections was found in the HIV group. Immunosuppressive regimens did not differ, but a trend was observed toward lower use of anti-thymocyte globulin in the group of HIV-infected recipients (P = 0.079). The HIV-positive recipient group presented a higher incidence of treated AR (P = 0.036) and DGF (P = 0.044). Chronic Kidney Disease Epidemiology Collaboration estimated that glomerular filtration rate was similar at 6 months (P = 0.374) and at 12 months (P = 0.957). The median number of infections per patient was higher in the HIV-infected group (P = 0.018). The 1-year patient survival (P < 0.001) and graft survival (P = 0.004) were lower, but acceptable, in the group of HIV-infected patients. CONCLUSIONS: In the Brazilian experience, despite somewhat inferior outcomes, kidney transplantation is an adequate therapy for selected HIV-infected recipients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / Terapia de Imunossupressão / Transplante de Rim / Rejeição de Enxerto / Falência Renal Crônica Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Transpl Infect Dis Assunto da revista: TRANSPLANTE Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Brasil País de publicação: Dinamarca
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / Terapia de Imunossupressão / Transplante de Rim / Rejeição de Enxerto / Falência Renal Crônica Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Transpl Infect Dis Assunto da revista: TRANSPLANTE Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Brasil País de publicação: Dinamarca