Preliminary Experience With Renal Transplantation in HIV+ Recipients: Low Acute Rejection and Infection Rates

Abstract

Our findings suggest that HIV+ patients on highly active antiretroviral therapy can undergo successful renal transplantation with a low incidence of both AR and AIDS-associated and non-AIDS associated infections, despite associated risk factors for poorer outcome. Our encouraging but preliminary results with this protocol will need to be verified in larger numbers of HIV+ renal allograft recipients with longer follow-up.

Urologic complications of HIV and AIDS

“…14,15 Although patients with HIV are usually excluded from dialysis and renal transplantation, there are now several reports in the literature of successful renal transplantation in HIV-positive recipients on HAART. Gruber and colleagues 16 reported acute rejection rates between 43% and 67% in patients with renal transplants and HIV, and patient and graft survivals of 100% and 88%, respectively.…”

Solid organ transplantation in HIV‐infected individuals: an update

“…Gruber et al tested the hypothesis that the incidence of acute rejection could be reduced with a modified immunosuppression protocol that includes induction therapy with an anti-IL-2 receptor antibody, higher cyclosporine trough target levels and monitoring pre-dose mycophenolic acid concentrations [11]. In their single-centre retrospective study of 8 HIVþ kidney transplant recipients with these immunosuppression modifications, the rate of rejection was only 13% after a median follow-up of 15 months.…”

Infectious Complications in Kidney Transplantation

“…Case series have documented successful outcomes of kidney transplant recipients with HIV (Gruber et al, 2008). However, these HIV patients had been carefully selected and adequately treated for HIV at the time of transplantation.…”