Report of Four Simultaneous Pancreas–Kidney Transplants in HIV-Positive Recipients With Favorable Outcomes

Grossi, Paolo; Righi, Elda; Gasperina, Daniela Dalla; Donati, D; Tozzi, Matteo; Mangini, Monica; Astuti, Noemi; Cuffari, Salvatore; Castelli, Patrizio; Carcano, Giulio; Dionigi, Gianlorenzo; Boggi, Ugo; Costa, Alessandro Nanni; Dionigi, Renzo

doi:10.1111/j.1600-6143.2011.03906.x

Cited by 28 publications

(24 citation statements)

References 18 publications

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“…Only one patient has been reported as having died, after SPK transplantation, resulting from bacterial sepsis at nine months [1]. Graft failure has been reported in two cases [1,2]. The remaining five organ grafts have functioned at follow up between 5 and 84 months [2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

“…Balancing medication interactions between antiretroviral therapy and immunosuppressive therapy remains a challenge. Eight cases of simultaneous pancreas and kidney (SPK) transplantation in HIV patients with type 1 diabetes mellitus (T1DM) have been reported with good outcomes [1][2][3][4][5]. At transplantation, all patients were under the age of 50 years, with undetectable HIV RNA blood levels.…”

Section: Introductionmentioning

confidence: 99%

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The First Simultaneous Pancreas, Renal Transplant in a Patient with HIV in Australia

Hasan¹,

Wong²,

Webster³

et al. 2018

J HIV Retrovirus

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We report the first case of a simultaneous pancreas and renal transplantation, in Australia, in a 45 year old male with long standing human immunodeficiency virus infection, type 1 diabetes mellitus and diabetic nephropathy requiring haemodialysis. This patient experienced previous virological failure and subsequent resistance to most nucleoside and non-nucleoside reverse transcriptase inhibitors. However, using novel combinations of anti-retroviral agents, along with careful monitoring, successful outcomes were achieved during the peri and post transplantation period, with excellent pancreas and renal graft function at one year.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The First Simultaneous Pancreas, Renal Transplant in a Patient with HIV in Australia

Hasan¹,

Wong²,

Webster³

et al. 2018

J HIV Retrovirus

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“…Recent legislation in the US, however, may permit selective transplantation of organs from HIV-positive donors into appropriate HIV-positive recipients. This practice has been performed successfully in SPKT in other countries [23].…”

Section: Contraindications To Organ Donationmentioning

confidence: 96%

Expanding the Pancreas Donor Pool

Fridell

Stratta

2014

Curr Transpl Rep

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Currently underutilized and in somewhat short supply, the pancreas allograft is a relatively scarce resource. Despite factors such as increased demand, positive changes in organ donation rates, and the liberalization of 'organ-acceptable' criteria, there has been a decline in the number of deceased donor pancreas transplants performed in the US. Concomitantly, there has been an increase in similar transplants performed in other countries. While it is understandable that there are a multiplicity of factors to be considered in the evaluation of the potential pancreas allograft donor in an attempt to minimize graft loss and morbidity, it is a simple truth that as a result there are unused transplantable organs. This paper will deal with the multifaceted problem of pancreas underutilization and will discuss strategies that could lead to the expansion of the pancreas donor pool.

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“…Several case reports suggest that SPK is feasible in individuals with HIV, although outcomes are mixed [52][53][54][55]. The largest series of four patients with HIV and ESRD with mean follow-up of 2-5 years revealed that all four patients had complications requiring re-exploration.…”

Section: Hivmentioning

confidence: 99%

“…However, all patients had a return to undetectable viral load following reintroduction of retroviral therapy post-transplantation. [53] The primary concerns for solid organ transplant in HIV+ patients include risk of postoperative infectious complications with added immunosuppression, increased renal toxicity with the combination of antiretroviral drugs and nephrotoxic immunosuppressants, and altered cellular-mediated immunity leading to potential increased risk of rejection. The very limited data available to evaluate pancreas transplant suggests that while it is technically feasible, there may be a higher rate of complications and graft failure.…”

Section: Hivmentioning

confidence: 99%

Pancreas Transplantation of Non-Traditional Recipients

Sayed

Turgeon

2014

Curr Transpl Rep

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Solid organ pancreas transplantation is a durable treatment for establishing normal blood glucose levels in patients with diabetes. Historically, younger patients with type 1 diabetes have been the primary recipients of pancreas transplants. As surgical techniques and post-operative immunosuppression regimens have continued to improve, indications have expanded such that non-traditional recipients are being evaluated for pancreas transplantation. These recipients include patients with type 2 diabetes, patients older than 50 years of age, and patients with chronic infectious diseases, including HIV and HCV. Despite limited literature in these patient populations, pancreas transplantation is a viable treatment for endocrine pancreas failure in appropriately selected patients, regardless of disease etiology or age. This review summarizes the current literature on pancreas transplantation in non-traditional recipients.

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Report of Four Simultaneous Pancreas–Kidney Transplants in HIV-Positive Recipients With Favorable Outcomes

Abstract: The advent of combined antiretroviral therapy (cART) dramatically changed the view of human immunodeficiency virus (HIV) infection as an exclusion criterion for

Cited by 28 publications

References 18 publications

The First Simultaneous Pancreas, Renal Transplant in a Patient with HIV in Australia

The First Simultaneous Pancreas, Renal Transplant in a Patient with HIV in Australia

Expanding the Pancreas Donor Pool

Pancreas Transplantation of Non-Traditional Recipients

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