Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 679-687 |
| Number of pages | 9 |
| Journal | American Journal of Transplantation |
| Volume | 16 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2016 |
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ASJC Scopus subject areas
- Transplantation
- Immunology and Allergy
- Pharmacology (medical)
Cite this
Liver Retransplantation in Patients with HIV-1 Infection : An International Multicenter Cohort Study. / Agüero, F.; Rimola, A.; Stock, P.; Grossi, P.; Rockstroh, J. K.; Agarwal, K.; Garzoni, C.; Barcan, L. A.; Maltez, F.; Manzardo, C.; Mari, M.; Ragni, M. V.; Anadol, E.; Di Benedetto, F.; Nishida, Seigo; Gastaca, M.; Miró, Jose M.
In: American Journal of Transplantation, Vol. 16, No. 2, 01.02.2016, p. 679-687.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Liver Retransplantation in Patients with HIV-1 Infection
T2 - An International Multicenter Cohort Study
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, Seigo
AU - Gastaca, M.
AU - Miró, Jose M.
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.
UR - http://www.scopus.com/inward/record.url?scp=84957956290&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84957956290&partnerID=8YFLogxK
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 -