Date: Tuesday, June 5, 2018
Session Name: Concurrent Session: New Frontiers in HIV and Hepatitis
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.
|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|
|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 June 26, 2019.
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