High incidence of delayed graft function in HIV-infected kidney transplant recipients.
Transpl Int
; 26(9): 893-902, 2013 Sep.
Article
em En
| MEDLINE
| ID: mdl-23841527
ABSTRACT
Kidney transplantation (KT) outcomes in human immunodeficiency virus (HIV)-infected recipients are under continuous research. High incidence of early post-transplant complications such as acute rejection has been observed. A multicenter study including HIV-infected patients who underwent KT in Spain, from 2001 to 2011, was performed. The study population included 108 recipients, 36 HIV-infected, and 72 matched HIV-negative KT recipients. HIV-infected recipients developed more delayed graft function (DGF) (52% vs. 21%, P < 0.001). One- and 3-year graft survival was 91.6% and 86.2% in HIV-infected patients, and 97.1% and 94.7% in HIV-negative patients (P = 0.052). In two-variate Cox analysis, HIV infection was not a predictor of graft loss after adjusting for time on dialysis, acute rejection, and DGF. Multivariate analysis for DGF revealed HIV-positive status as independent risk factor. We analyzed the evolution of immunosuppressive and antiretroviral therapy (ART). In HIV-infected patients tacrolimus trough levels were very high in the first week and significantly lower in the second week post-transplant (P = 0.042). Post-transplant ART was significantly changed protease inhibitors use decreased (P = 0.034) and integrase inhibitor use increased (P < 0.001). DGF is another frequent early complication in HIV-infected recipients that can affect graft survival. Strategies to prevent DGF and antiretroviral regimes with less drug interactions could improve outcomes.
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Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
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Transplante de Rim
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Insuficiência Renal
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Função Retardada do Enxerto
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article