TY - JOUR
T1 - Liver Retransplantation in Patients with HIV-1 Infection
T2 - An International Multicenter Cohort Study
AU - The FIPSE/NIH HIVTR/ NEAT023 Investigators
AU - Agüero, F.
AU - Rimola, A.
AU - Stock, P.
AU - Grossi, P.
AU - Rockstroh, J. K.
AU - Agarwal, K.
AU - Garzoni, C.
AU - Barcan, L. A.
AU - Maltez, F.
AU - Manzardo, C.
AU - Mari, M.
AU - Ragni, M. V.
AU - Anadol, E.
AU - Di Benedetto, F.
AU - Nishida, S.
AU - Gastaca, M.
AU - Miró, J. M.
AU - Pedreira, J. D.
AU - Castro, M. A.
AU - López, S.
AU - Suárez, F.
AU - Vazquez, P.
AU - Blanch, J.
AU - Brunet, M.
AU - Cervera, C.
AU - de Lazzari, E.
AU - Fondevila, C.
AU - Forner, A.
AU - Fuster, J.
AU - Freixa, N.
AU - GarcÃa-Valdecasas, J. C.
AU - Gil, A.
AU - Gatell, J. M.
AU - Laguno, M.
AU - MartÃnez, M.
AU - Mallolas, J.
AU - Monras, M.
AU - Moreno, A.
AU - Murillas, J.
AU - Paredes, D.
AU - Pérez, I.
AU - Torres, F.
AU - Tural, C.
AU - Tuset, M.
AU - Antela, A.
AU - Diego, J.
AU - Roth, D.
AU - Schiff, E.
AU - Burke, G.
AU - Jayaweera, D.
N1 - Funding Information:
We dedicate this article to Dr. Inaki Perez (Barcelona, Spain), who played a key role in this project and died in April 2014. We also acknowledge Ms. Maite Manzanera from the Fundaci"on para la Investigaci"on y Prevenci"on del Sida en Espa~na (FIPSE), Madrid, Spain, for her constant support from the beginning of the project. Finally, we would like to acknowledge the contribution of United Network for Organ Sharing (UNOS). This study was funded by the European AIDS Treatment Network (NEAT) Integration Grant Project (NEAT 023), Rome (Italy). The national cohorts were funded by the following grants: the Spanish cohort by the Spanish Foundation for AIDS Research and Prevention (projects FIPSE 05, FIPSE 08, FIPSE 12, FIPSE 13, andFIPSE14,Madrid, Spain), the SEIMC/GESIDAFoundation(Madrid,Spain), and the Spanish Ministry of Health, ProjectnumberEC11-150 (Madrid, Spain); the Solid Organ Transplantation in HIV: Multi-Site Study (AI052748) by the National Institute of Allergy and Infectious Diseases (United States); and the Swiss HIV Cohort Study by the Swiss National Science Foundation (SNF grant 33CSC0-108787). Dr. Fernando Aguero held a Rio Hortega Research Grant (CM12/00195) from the Instituto de Salud Carlos III and the Ministerio de Economia y Competitividad, Madrid (Spain) in 2013-2015.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Liver retransplantation is performed in HIV-infected patients, although its outcome is not well known. In an international cohort study (eight countries), 37 (6%; 32 coinfected with hepatitis C virus [HCV] and five with hepatitis B virus [HBV]) of 600 HIV-infected patients who had undergone liver transplant were retransplanted. The main indications for retransplantation were vascular complications (35%), primary graft nonfunction (22%), rejection (19%), and HCV recurrence (13%). Overall, 19 patients (51%) died after retransplantation. Survival at 1, 3, and 5 years was 56%, 51%, and 51%, respectively. Among patients with HCV coinfection, HCV RNA replication status at retransplantation was the only significant prognostic factor. Patients with undetectable versus detectable HCV RNA had a survival probability of 80% versus 39% at 1 year and 80% versus 30% at 3 and 5 years (p = 0.025). Recurrence of hepatitis C was the main cause of death in the latter. Patients with HBV coinfection had survival of 80% at 1, 3, and 5 years after retransplantation. HIV infection was adequately controlled with antiretroviral therapy. In conclusion, liver retransplantation is an acceptable option for HIV-infected patients with HBV or HCV coinfection but undetectable HCV RNA. Retransplantation in patients with HCV replication should be reassessed prospectively in the era of new direct antiviral agents.
AB - Liver retransplantation is performed in HIV-infected patients, although its outcome is not well known. In an international cohort study (eight countries), 37 (6%; 32 coinfected with hepatitis C virus [HCV] and five with hepatitis B virus [HBV]) of 600 HIV-infected patients who had undergone liver transplant were retransplanted. The main indications for retransplantation were vascular complications (35%), primary graft nonfunction (22%), rejection (19%), and HCV recurrence (13%). Overall, 19 patients (51%) died after retransplantation. Survival at 1, 3, and 5 years was 56%, 51%, and 51%, respectively. Among patients with HCV coinfection, HCV RNA replication status at retransplantation was the only significant prognostic factor. Patients with undetectable versus detectable HCV RNA had a survival probability of 80% versus 39% at 1 year and 80% versus 30% at 3 and 5 years (p = 0.025). Recurrence of hepatitis C was the main cause of death in the latter. Patients with HBV coinfection had survival of 80% at 1, 3, and 5 years after retransplantation. HIV infection was adequately controlled with antiretroviral therapy. In conclusion, liver retransplantation is an acceptable option for HIV-infected patients with HBV or HCV coinfection but undetectable HCV RNA. Retransplantation in patients with HCV replication should be reassessed prospectively in the era of new direct antiviral agents.
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U2 - 10.1111/ajt.13461
DO - 10.1111/ajt.13461
M3 - Article
C2 - 26415077
AN - SCOPUS:84957956290
VL - 16
SP - 679
EP - 687
JO - American Journal of Transplantation
JF - American Journal of Transplantation
SN - 1600-6135
IS - 2
ER -