Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
Outcomes among HIV+ Tx continue to improve despite the established risk of rejection and calcineurin-nephrotoxicity. We sought to compare outcomes among HIV+ Tx vs. HIV- Tx receiving similar immunosuppression protocols.
Methods: Retrospective analysis of all HIV +/- Tx performed since 2011, receiving basiliximab + calcineurin inhibitor based immunosuppression. HIV+ Tx received IVIg as an additional induction agent. Clinical outcomes were assessed between the HIV+ Tx and HIV- Tx groups at 1 year post-transplant. All rejections were considered, including subclinical and borderline.
Results: In total, 39 patients were reviewed. Table 1 illustrates comparable recipient and donor characteristics. Donor age was younger among the HIV+ Tx, but KDRI was similar. Despite the potential for drug interactions among HIV+ Tx, tac troughs levels were comparable at all time points (Figure 1). Clinical post-Tx outcomes are comparable at all time points (Table 2). On follow-up biopsies, the incidence of mild fibrosis was more common among HIV + Tx (62% vs. 36%).
Conclusion: Immunosuppression protocols utilized among HIV- Tx can attain similar outcomes in HIV+ Tx. Standard markers of allograft function (i.e. eGFR) may not reflect degree of fibrosis on Biopsies in the HIV+ Tx. This may be reflected by the continuation of similar tac troughs throughout the post-Tx period..
|Table 1||HIV (-)||HIV (+)||p-value|
|Recipient Age||57 ± 14||51 ± 8||0.03|
|HD vintage (months)||41 ± 40||81 ± 38||0.004|
|Incidence of Delayed Graft Function||28%||46%||0.23|
|Donor age||42 ± 13||30 ± 11||0.004|
|KDRI score||0.99 ± 0.26||0.94 ± 0.16||0.71|
|Table 2||HIV (-)||HIV (+)||p-value|
|Proteinuria @ 1 year||0.18 ± 0.10||0.26 ± 0.23||0.73|
|eGFR @ 1 year (mL/min)||57 ± 18||58 ± 20||1.0|
|Incidence of BK viremia @ 1 year||24%||8%||0.28|
To cite this abstract in AMA style:Panarey L, Malat G, Sharma A, Ranganna K, Reich D, Xiao G, Doyle A. Similar Outcomes Can Be Expected Among HIV (+) Kidney Transplant Recipients (HIV+ Tx) Vs. HIV (-) Kidney Transplant Recipients (HIV- Tx) Receiving Similar Immunosuppression Protocols [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/similar-outcomes-can-be-expected-among-hiv-kidney-transplant-recipients-hiv-tx-vs-hiv-kidney-transplant-recipients-hiv-tx-receiving-similar-immunosuppression-protocols/. Accessed May 20, 2019.
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