Kidney Transplantation in HIV-Positive Patients: A Single-Center, 16-Year Experience
| Autor: | Gregory Malat, Rahul M. Jindal, Suzanne M. Boyle, Meera N. Harhay, Gary Xiao, Mysore S. Anil Kumar, Dong Heun Lee, Alden Doyle, Stephen Guy, Karthik Ranganna |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Time Factors medicine.medical_treatment Population 030232 urology & nephrology Single Center Belatacept Hospitals University 03 medical and health sciences 0302 clinical medicine HIV Seropositivity medicine Humans 030212 general & internal medicine education Kidney transplantation Aged Retrospective Studies education.field_of_study Donor selection business.industry Immunosuppression Perioperative medicine.disease Kidney Transplantation Transplantation surgical procedures operative Nephrology Kidney Failure Chronic Female business medicine.drug |
| Zdroj: | American Journal of Kidney Diseases. 73:112-118 |
| ISSN: | 0272-6386 |
| Popis: | Hahnemann University Hospital has performed 120 kidney transplantations in human immunodeficiency virus (HIV)-positive individuals during the last 16 years. Our patient population represents ∼10% of the entire US population of HIV-positive kidney recipients. In our earlier years of HIV transplantation, we noted increased rejection rates, often leading to graft failure. We have established a multidisciplinary team and over the years have made substantial protocol modifications based on lessons learned. These modifications affected our approach to candidate evaluation, donor selection, perioperative immunosuppression, and posttransplantation monitoring and resulted in excellent posttransplantation outcomes, including 100% patient and graft survival at 1 year and patient and graft survival at 3 years of 100% and 96%, respectively. We present key clinical data, including a granular patient-level analysis of the associations of antiretroviral therapy regimens with long-term survival, cellular and antibody-mediated rejection rates, and the causes of allograft failures. In summary, we provide details on the evolution of our approach to HIV transplantation during the last 16 years, including strategies that may improve outcomes among HIV-positive kidney transplantation candidates throughout the United States. |
| Databáze: | OpenAIRE |
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