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Corresponding Author: Jack Harbell, MD, University Of California, San Francisco, 513 Parnassus Ave., Room S321, San Francisco, CA 94143-0470 USA, jack.harbell@ucsfmedctr.org, Phone: 415-476-126-, Fax: 415-502-1259

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Allergy And Infectious Diseases or the National Institutes of Health.

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Research Funding:

This work was supported by the Solid Organ Transplantation in HIV: Multi-Site Study (AI052748) funded by the National Institute of Allergy and infectious Diseases.

Surgical Complications in 275 Human Immunodeficiency Virus (HIV) Infected Liver and/or Kidney Transplant Recipients

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Journal Title:

Journal of Surgical Research

Volume:

Volume 152, Number 3

Publisher:

, Pages 376-381

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background: This report examines the surgical safety and complications (SC) among 125 liver (L) and 150 kidney (K) HIV+ transplant (TX) recipients in a prospective non-randomized US multicenter trial. Methods: Subjects required CD4+ T-cell count > 200/100 cells/mm3 (K/L) & undetectable plasma HIV-1 RNA (VL) (K) or expected post-transplant suppression (L). Impact of SCs (N≥7) was evaluated using proportional hazards (PH) models. Baseline morbidity predictors for SCs (N≥7) were assessed in univariate PH models. Results: At median 2.7 [interquartile range (IQR) 1.9, 4.1] & 2.3 [1.0, 3.7] years post- TX, 3-month & 1-year graft survival were [K] 96% (CI 91%,98%) & 91% (85%,94%) & [L] 91% (85%,95%) & 77% (69%,84%). 14K and 28L graft losses occurred in the first year; 6K and 11L were in the first 3 months. 26(17%) K and 43 (34%) L experienced 29 and 62 SCs, respectively. In the liver multivariate model, re-exploration was marginally associated (HR: 2.8; 95% CI: 1.0-8.4; p=0.06) with increased risk of graft loss, while higher MELD pre-transplant (HR: 1.07 per point increase; 95% CI: 1.01-1.14; p=0.02), and detectable viral load pre-TX (HR: 3.6; 95% CI: 0.9-14.6; p=0.07) was associated with an increased risk of wound infections/dehiscence. Conclusions: The rates and outcomes of surgical complications are similar to what has been observed in the non-HIV setting in carefully selected HIV-infected liver and kidney TX recipients.

Copyright information:

© 2012 Mosby, Inc. Published by Elsevier Inc. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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