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Transplants in HIV patients should proceed, but drug interactions a concern

MIAMI, Aug. 29 While historically surgeons have been reluctant to transplant patients with the human immunodeficiency virus (HIV), in recent years, some centers have begun to accept patients with well-controlled HIV as candidates for liver or kidney transplantation. Based on results of three studies from the United States and one from France, which collectively reported on 34 kidney and 17 liver transplants in HIV-positive patients, researchers conclude that organ transplantation should indeed be considered a treatment option for such patients.

Reporting at the XIX International Congress of The Transplantation Society being held at the Westin Diplomat Resort and Spa in Hollywood, Fla., the researchers said that after more than one year of follow-up, outcomes in patients with HIV are very similar to outcomes in transplant patients without HIV, and importantly, the immunosuppressive drugs used to control organ rejection seem to have little effect on HIV progression.

But, the researchers added, managing these anti-rejection drugs and the anti-retroviral therapies for HIV presents quite a challenge. Mindful that the drugs may interact with each other or be toxic, transplant teams must achieve just the right balance between the two types of drugs. Suppressing the immune system too much with high doses of the anti-rejection drug may allow the HIV infection to worsen. Too low a dose, and the organ may be rejected.

Surgeons are seeing more patients with HIV needing liver or kidney transplants because the so-called highly active anti-retroviral therapies (HAART) are allowing patients with HIV to live longer with fewer HIV-related complications. Yet for HIV patients who also have liver disease, such as hepatitis B or hepatitis C, longer life expectancy also may allow progression of their chronic liver disease to end-stage liver failure. Some patients with HIV are developing end-stage kidney failure as a result of their HIV infection or from the anti-ret
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Contact: Lisa Rossi
press@txmiami2002.com
412-916-3315
Transplantation Society
29-Aug-2002


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