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Solid organ transplantation in the HIV-infected patient: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice.
Clin Transplant. 2019 09; 33(9):e13499.CT

Abstract

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the management of transplantation in HIV-infected individuals. Transplantation has become the standard of care for patients with HIV and end-stage kidney or liver disease. Although less data exist for thoracic organ and pancreas transplantation, it is likely that transplantation is also safe and effective for these recipients as well. Despite what is typically a transient decline in CD4+ T lymphocytes, HIV remains well controlled and infection risks are similar to those of HIV-uninfected transplant recipients. The availability of effective directly active antivirals for the treatment of Hepatitis C is likely to improve outcomes in HIV and HCV co-infected individuals, a population previously noted to have decreased survival. Drug interactions remain an important consideration, and integrase inhibitor-based regimens are preferred due to the absence of interactions with calcineurin and mTOR inhibitors. Additionally, despite the use of more potent immunosuppression, rejection rates exceed those found in HIV-uninfected recipients. Ongoing research evaluating HIV-positive organ donors may provide support for utilizing these donors for HIV-positive patients in need of transplantation.

Authors+Show Affiliations

Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.Massachusetts General Hospital, Boston, Massachusetts.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30773688

Citation

Blumberg, Emily A., et al. "Solid Organ Transplantation in the HIV-infected Patient: Guidelines From the American Society of Transplantation Infectious Diseases Community of Practice." Clinical Transplantation, vol. 33, no. 9, 2019, pp. e13499.
Blumberg EA, Rogers CC, American Society of Transplantation Infectious Diseases Community of Practice. Solid organ transplantation in the HIV-infected patient: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9):e13499.
Blumberg, E. A., & Rogers, C. C. (2019). Solid organ transplantation in the HIV-infected patient: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clinical Transplantation, 33(9), e13499. https://doi.org/10.1111/ctr.13499
Blumberg EA, Rogers CC, American Society of Transplantation Infectious Diseases Community of Practice. Solid Organ Transplantation in the HIV-infected Patient: Guidelines From the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33(9):e13499. PubMed PMID: 30773688.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Solid organ transplantation in the HIV-infected patient: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. AU - Blumberg,Emily A, AU - Rogers,Christin C, AU - ,, Y1 - 2019/04/21/ PY - 2019/02/01/received PY - 2019/02/12/accepted PY - 2019/2/19/pubmed PY - 2020/10/2/medline PY - 2019/2/19/entrez KW - acquired immunodeficiency syndrome KW - human immunodeficiency virus SP - e13499 EP - e13499 JF - Clinical transplantation JO - Clin Transplant VL - 33 IS - 9 N2 - These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the management of transplantation in HIV-infected individuals. Transplantation has become the standard of care for patients with HIV and end-stage kidney or liver disease. Although less data exist for thoracic organ and pancreas transplantation, it is likely that transplantation is also safe and effective for these recipients as well. Despite what is typically a transient decline in CD4+ T lymphocytes, HIV remains well controlled and infection risks are similar to those of HIV-uninfected transplant recipients. The availability of effective directly active antivirals for the treatment of Hepatitis C is likely to improve outcomes in HIV and HCV co-infected individuals, a population previously noted to have decreased survival. Drug interactions remain an important consideration, and integrase inhibitor-based regimens are preferred due to the absence of interactions with calcineurin and mTOR inhibitors. Additionally, despite the use of more potent immunosuppression, rejection rates exceed those found in HIV-uninfected recipients. Ongoing research evaluating HIV-positive organ donors may provide support for utilizing these donors for HIV-positive patients in need of transplantation. SN - 1399-0012 UR - https://www.unboundmedicine.com/medline/citation/30773688/Solid_organ_transplantation_in_the_HIV_infected_patient:_Guidelines_from_the_American_Society_of_Transplantation_Infectious_Diseases_Community_of_Practice_ L2 - https://doi.org/10.1111/ctr.13499 DB - PRIME DP - Unbound Medicine ER -