Heart Transplantation in Human Immunodeficiency Virus–Positive Patients

Uriel, Nir; Jorde, Ulrich P.; Cotarlan, Vlad; Colombo, P.C.; Farr, Maryjane; Restaino, Susan; Lietz, Katherine; Naka, Y.; Deng, Mario C.; Mancini, Donna

doi:10.1016/j.healun.2009.04.005

Cited by 71 publications

(49 citation statements)

References 8 publications

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“…Published experience with HT in the setting of HIV infection is scant. The present review includes data from small retrospective cohort studies, case series, and cases published in indexed journals (2)(3)(4)(5)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). The data presented comprise reports of patients who acquired HIV infection before, during and after HT.…”

Section: Experience With Ht In Hiv-infected Patientsmentioning

confidence: 99%

“…Published Data on HT in the Pre-cART Era (1982)(1983)(1984)(1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996) The 11 published cases of HT in HIV-infected patients in the pre-cART era are summarized in Table S1 (3,16,17,19,20,22,(25)(26)(27)(28). In all but one case, HIV infection was acquired through the donor graft, blood transfusion or blood products received in the perioperative period or shortly after HT.…”

Section: Experience With Ht In Hiv-infected Patientsmentioning

confidence: 99%

“…Heart transplantation (HT) is currently the most established long-term approach for suitable candidates with no other options for therapy, but even in high-volume HT centers, HIV-infected patients are rarely considered candidates for HT (2). Current evidence from small retrospective cohort studies and case series indicates that HT is safe in carefully selected HIV-infected patients and that its outcomes are similar to those seen in non-HIVinfected patients (2)(3)(4)(5). Nevertheless, more information is needed to accurately establish the long-term safety and efficacy of HT in the setting of HIV infection.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

An Update on Heart Transplantation in Human Immunodeficiency Virus–Infected Patients

Agüero

Castel

Cocchi

et al. 2016

American Journal of Transplantation

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Section: Experience With Ht In Hiv-infected Patientsmentioning

confidence: 99%

Section: Experience With Ht In Hiv-infected Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An Update on Heart Transplantation in Human Immunodeficiency Virus–Infected Patients

Agüero

Castel

Cocchi

et al. 2016

American Journal of Transplantation

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“…In this subset ofpatients, the current follow-up suggests that survival might overlap with that of patients without HIY. Moreover, no significant AIDS-related infections or complications occurred (9).…”

Section: Discussionmentioning

confidence: 95%

“…This has prompted individual US heart transplant centers to wait list and transplant HIY-infected patients fulfilling strict virological and clinical criteria (7)(8)(9).…”

Section: Heartmentioning

confidence: 99%

Management of Immunosuppression and Antiviral Treatment before and after Heart Transplant for HIV-Associated Dilated Cardiomyopathy

Durante‐Mangoni

Maiello

Limongelli

et al. 2014

Int J Immunopathol Pharmacol

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Infection with HIV may lead to the development of cardiomyopathy as improved antiretroviral regimens continue to prolong patient life. However, advanced therapeutic options, such as heart transplant, have until recently been precluded to HIV-positive persons. A favorable long-term outcome has been obtained after kidney or liver transplant in HIV-positive recipients fulfilling strict virological and clinical criteria. We recently reported the first heart transplant in a HIV-infected patient carried out in our center. In this article, we detail the major challenges we faced with the management of antiretroviral and immunosuppressive treatments over the first 3 years post-transplant. The patient had developed dilated cardiomyopathy while on antiretroviral treatment with zidovudine, lamivudine and efavirenz. He was in WHO Stage 1 of HIV infection and had normal CD4+ count and persistently undetectable HIV-RNA. In spite of cardiac resynchronization therapy and maximal drug therapy, the patient progressed to end stage heart failure, requiring heart transplant. He was placed on a standard immune suppressive protocol including cyclosporine A and everolimus. Despite its potential pharmacokinetic interaction with efavirenz, everolimus was chosen to reduce the long-term risk of opportunistic neoplasia. Plasma levels of both drugs were monitored and remained within the target range, although high doses of everolimus were needed. There were no infectious, neoplastic or metabolic complications during a 3-year follow-up. In summary, our experience supports previous data showing that cardiac transplantation should not be denied to carefully selected HIV patients. Careful management of drug interactions and adverse events is mandatory.

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