Heart and Lung Transplantation Outcomes in HIV-Positive Recipients
1Infectious Diseases, Cleveland Clinic, Cleveland, OH
2Infectious Diseases, Yale University, New Haven, CT
3Infectious Diseases, University Hospital Zurich, Zurich, Switzerland
4Pharmacy, Houston Methodist Hospital, Houston, TX
5Infectious Diseases, Mater Hospital, Dublin, Ireland
6Infectious Diseases, University Insubria, Varese, Italy
7Infectious Diseases, Mount Sinai Hospital, New York, NY.
Meeting: 2018 American Transplant Congress
Abstract number: 568
Keywords: Heart transplant patients, Heart/lung transplantation, HIV virus, Lung transplantation
Session Information
Session Name: Concurrent Session: New Frontiers in HIV and Hepatitis
Session Type: Concurrent Session
Date: Tuesday, June 5, 2018
Session Time: 4:30pm-6:00pm
Presentation Time: 5:18pm-5:30pm
Location: Room 4C-3
Purpose: Data for HIV+ patients receiving heart (HT) or lung transplantation (LT) are limited but appear to demonstrate acceptable outcomes. We aimed to add to the reported number of outcomes and management strategies.
Methods: Adult HIV+ patients receiving HT, LT or HLT with >1 yr follow up were included. IRB approval was obtained at each site. Baseline and follow up data were retrospectively obtained, de-identified and shared securely.
Results: From 2000-2016, 21 HT, 7 LT and 1 HLT were reported in 29 HIV+ recipients from 14 sites in US/Europe. Five HTs were reported elsewhere. Median follow up was 989d. At baseline, all had HIV control on antivirals.
| Heart Transplant
N=21 |
Lung Transplant
N=7 |
Heart/Lung Transplant
N=1 |
|
| Age at transplant (median) | 48 | 57 | 54 |
| Underlying heart or lung disease | NICM 17; ICM 4 | ILD/IPF 4; COPD1; CF1; other 1 | pHTN |
| Median base line CD4 (range) | 399 cell/ul (153-1580) | 638 cell/ul(264-1496) | 78 cell/ul |
| Anti-retroviral 3rd drug (2 NRTI + x) | PI (4); Integrase (8); NNRTI (8); other (1) | PI (3); Integrase (3); NNRTI (2) | Integrase |
| Induction, basiliximab or ATG | 3 (14%) | 3 (42%) | no |
| CNI, tacro;CSA | 16;5 | 7;0 | tacro |
| 1 yr patient survival | 19 (90.4%) | 6 (85.7%) | alive |
| Rejection, 1 yr | 13/21 (62%) | 2/7 (29%); 1/7 (BOS) | 1 |
| Infection, 1 yr | 8/21 (39%) | 5/7 (72%); | 0 |
| 3 yr patient survival | 11/15 (73.3%) | 4/5 (80%) | NA |
| 5 yr patient survival | 7/11 (63.6%) | 3/4 (75%) | NA |
Conclusions: Survival for HIV+ LT was similar to that in the general LT population*. Post-LT infection was common. For HT, survival was similar to the general HT population at 1 yr but decreased at 3 & 5 yrs*. Rejection was more common than expected in HT and may have contributed to decreased survival. As with other HIV+ organ transplants, early, aggressive immunosuppression may be needed to avoid rejection.
* ISHLT Registry 2017.
CITATION INFORMATION: Koval C., Malinis M., Mueller N., Krisl J., Hannan M., Grossi P., Huprikar S. Heart and Lung Transplantation Outcomes in HIV-Positive Recipients Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Koval C, Malinis M, Mueller N, Krisl J, Hannan M, Grossi P, Huprikar S. Heart and Lung Transplantation Outcomes in HIV-Positive Recipients [abstract]. https://atcmeetingabstracts.com/abstract/heart-and-lung-transplantation-outcomes-in-hiv-positive-recipients/. Accessed December 3, 2024.« Back to 2018 American Transplant Congress