Renal transplantation in HIV-infected patients: the Paris experience

Am J Transplant. 2010 Oct;10(10):2263-9. doi: 10.1111/j.1600-6143.2010.03258.x. Epub 2010 Sep 14.

Abstract

Kidney transplantation is now considered as a reasonable option for HIV-infected patients with end-stage renal disease. We describe here a retrospective study conducted in five transplantation centers in Paris. Twenty-seven patients were included. Immunosuppressive protocol associated an induction therapy and a long-term treatment combining mycophenolate mofetil, steroids and either tacrolimus or cyclosporine. All the patients had protocol biopsies at 3 months and 1 year. Patient's survival was 100% at 1 year and 98% at 2 years. Graft survival at 1 and 2 years is 98% and 96% at 1 and 2 years, respectively. The mean glomerular filteration rate values at 12 and 24 months were 60.6 mL/min/1.73 m² (range 23-98) and 65.4 mL/min/1.73 m² (range 24-110), respectively. Acute cellular rejection was diagnosed in four cases (15%). Because of high trough levels of calcineurin inhibitor, protease-inhibitor therapies were withdrawn in 11 cases. HIV disease progression was not observed. One patient developed B-cell lymphoma. In conclusion, our study confirms the safety of renal transplantation in HIV-infected patients with few adverse events and a low incidence of acute rejection.

MeSH terms

  • Adult
  • Cyclosporine / administration & dosage
  • Female
  • Graft Rejection / epidemiology
  • Graft Survival
  • HIV Infections / complications*
  • HIV Infections / surgery
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation* / adverse effects
  • Male
  • Middle Aged
  • Paris / epidemiology
  • Retrospective Studies
  • Tacrolimus / administration & dosage

Substances

  • Immunosuppressive Agents
  • Cyclosporine
  • Tacrolimus