HOPE in action: A prospective multicenter pilot study of liver transplantation from donors with HIV to recipients with HIV

被引：38

作者：

Durand, Christine M. ^{[1
]}

Florman, Sander ^{[2
]}

Motter, Jennifer D. ^{[3
]}

Brown, Diane ^{[1
]}

Ostrander, Darin ^{[1
]}

Yu, Sile

Liang, Tao ^{[1
]}

Werbel, William A. ^{[1
]}

Cameron, Andrew ^{[3
]}

Ottmann, Shane ^{[3
]}

Hamilton, James P. ^{[1
]}

Redd, Andrew D. ^{[1
,4
]}

Bowring, Mary G. ^{[3
]}

Eby, Yolanda ^{[5
]}

Fernandez, Reinaldo E. ^{[1
]}

Doby, Brianna

Labo, Nazzarena ^{[6
]}

Whitby, Denise ^{[6
]}

Miley, Wendell ^{[6
]}

Friedman-Moraco, Rachel ^{[7
]}

Turgeon, Nicole ^{[7
]}

Price, Jennifer C. ^{[8
]}

Chin-Hong, Peter ^{[8
]}

Stock, Peter ^{[8
]}

Stosor, Valentina ^{[9
]}

Kirchner, Varvara A. ^{[10
]}

Pruett, Timothy ^{[10
]}

Wojciechowski, David ^{[11
]}

Elias, Nahel ^{[11
]}

Wolfe, Cameron ^{[12
]}

Quinn, Thomas C. ^{[1
]}

Odim, Jonah

Morsheimer, Megan ^{[13
]}

Mehta, Sapna A. ^{[14
]}

Rana, Meenakshi M. ^{[15
]}

Huprikar, Shirish ^{[15
]}

Massie, Allan ^{[3
]}

Tobian, Aaron A. R. ^{[5
]}

Segev, Dorry L.

机构：

[1] Johns Hopkins Univ, Dept Med, Sch Med, Baltimore, MD USA

[2] Mt Sinai Hosp, Recanati Miller Transplantat Inst, New York, NY USA

[3] Johns Hopkins Univ, Dept Surg, Sch Med, Baltimore, MD USA

[4] NIAID, Labo Immunoregulat, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA

[5] Johns Hopkins Univ, Dept Pathol, Sch Med, Baltimore, MD USA

[6] Frederick Natl Lab Canc Res, Viral Oncol Sect, AIDS & Canc Virus Program, Frederick, MD USA

[7] Emory Univ, Dept Med, Atlanta, GA 30322 USA

[8] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA

[9] Northwestern Univ, Feinberg Sch Med, Div Infect Dis & Organ Transplantat, Chicago, IL USA

[10] Univ Minnesota, Minneapolis, MN USA

[11] Massachusetts Gen Hosp, Boston, MA 02114 USA

[12] Duke Univ, Divis Infect Dis, Med Ctr, Durham, NC USA

[13] NIAID, Div Allergy Immunol & Transplantat, NIH, 9000 Rockville Pike, Bethesda, MD 20892 USA

[14] NYU, Langone Transplant Inst, New York, NY USA

[15] Icahn Sch Med Mt Sinai, Dept Med, New York, NY 10029 USA

来源：

AMERICAN JOURNAL OF TRANSPLANTATION | 2022年 / 22卷 / 03期

基金：

美国国家卫生研究院;

关键词：

clinical research/practice; ethics and public policy; infection and infectious agents - viral: hepatitis C; infection and infectious agents - viral: human herpesvirus 8 (HHV-8); infection and infectious agents - viral: human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS); infectious disease; liver disease; liver disease: infectious; liver transplantation/hepatology; SEXUAL TRANSMISSION; POSITIVE KIDNEY; TERM OUTCOMES; UNITED-STATES; HEPATITIS-C; SURVIVAL; HUMAN-HERPESVIRUS-8; COINFECTION; INFECTION; DISEASE;

D O I：

10.1111/ajt.16886

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Liver transplantation (LT) from donors-with-HIV to recipients-with-HIV (HIV D+/R+) is permitted under the HOPE Act. There are only three international single-case reports of HIV D+/R+ LT, each with limited follow-up. We performed a prospective multicenter pilot study comparing HIV D+/R+ to donors-without-HIV to recipients-with-HIV (HIV D-/R+) LT. We quantified patient survival, graft survival, rejection, serious adverse events (SAEs), human immunodeficiency virus (HIV) breakthrough, infections, and malignancies, using Cox and negative binomial regression with inverse probability of treatment weighting. Between March 2016-July 2019, there were 45 LTs (8 simultaneous liver-kidney) at 9 centers: 24 HIV D+/R+, 21 HIV D-/R+ (10 D- were false-positive). The median follow-up time was 23 months. Median recipient CD4 was 287 cells/mu L with 100% on antiretroviral therapy; 56% were hepatitis C virus (HCV)-seropositive, 13% HCV-viremic. Weighted 1-year survival was 83.3% versus 100.0% in D+ versus D- groups (p = .04). There were no differences in one-year graft survival (96.0% vs. 100.0%), rejection (10.8% vs. 18.2%), HIV breakthrough (8% vs. 10%), or SAEs (all p > .05). HIV D+/R+ had more opportunistic infections, infectious hospitalizations, and cancer. In this multicenter pilot study of HIV D+/R+ LT, patient and graft survival were better than historical cohorts, however, a potential increase in infections and cancer merits further investigation.

引用

页码：853 / 864

页数：12

共 50 条

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