Document Detail

Impact of HIV seropositivity on graft and patient survival after cadaveric renal transplantation in the United States in the pre highly active antiretroviral therapy (HAART) era: an historical cohort analysis of the United States Renal Data System.
MedLine Citation:
PMID:  12421459     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: National statistics are presented for patient survival and graft survival in patients seropositive for the human immunodeficiency virus (HIV+) at the time of renal transplantation in the era prior to highly active antiretroviral therapy (HAART). METHODS: Historical cohort analysis of 63, 210 cadaveric solitary renal transplant recipients with valid HIV serology entries in the United States Renal Data System (USRDS) from 1 January 1987 to 30 June 1997. The medical evidence form was also used for additional variables but, because of fewer available values, was analyzed in a separate model. Outcomes were patient characteristics and survival associated with HIV+ status. RESULTS: Thirty-two patients (0.05%) in the study period were HIV+ at transplant. HIV+ patients were comparable to the national renal transplant population in terms of gender and ethnic distribution but were younger and had younger donors and better HLA matching than the USRDS population. Patient and graft three-year survival were significantly reduced in HIV+ recipients (53% graft, 83% patient survival) relative to the USRDS population (73% and 88%, respectively). In multivariate analysis, HIV+ status was independently associated with patient mortality and decreased graft survival in recipients of cadaveric kidney transplants. CONCLUSIONS: This analysis was retrospective and may underestimate the number of HIV+ patients transplanted in the United States. Although the clinical details of patient selection for transplant were unknown, these results show HIV+ patients can have successful outcomes after cadaveric renal transplantation, although outcomes are significantly different from HIV- recipients.
S J Swanson; A D Kirk; C W Ko; C A Jones; L Y Agodoa; K C Abbott
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Transplant infectious disease : an official journal of the Transplantation Society     Volume:  4     ISSN:  1398-2273     ISO Abbreviation:  Transpl Infect Dis     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-11-07     Completed Date:  2003-02-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100883688     Medline TA:  Transpl Infect Dis     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  144-7     Citation Subset:  IM    
Nephrology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
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MeSH Terms
Antiretroviral Therapy, Highly Active*
Cohort Studies
Graft Rejection
Graft Survival*
HIV Infections / complications*,  drug therapy
Kidney Transplantation / mortality*
Middle Aged
Multivariate Analysis
Survival Analysis
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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