Trasplante renal en pacientes con infección por virus de la inmunodeficiencia humana (VIH)

  1. Marta Santiago-González 1
  2. Victoria Gómez-Dos-Santos 1
  3. Álvarez Nadal, Marta
  4. Cristina Galeano-Álvarez 1
  5. Sara Jiménez-Álvaro 1
  6. Sandra Elías-Triviño 1
  7. Milagros Fernández-Lucas 1
  8. Francisco Javier Burgos-Revilla 1
  1. 1 Hospital Ramón y Cajal
    info

    Hospital Ramón y Cajal

    Madrid, España

    ROR https://ror.org/050eq1942

Revista:
RIECS: Revista de Investigación y Educación en Ciencias de la Salud

ISSN: 2530-2787

Ano de publicación: 2020

Volume: 5

Número: 2

Páxinas: 6-18

Tipo: Artigo

DOI: 10.37536/RIECS.2020.5.2.188 DIALNET GOOGLE SCHOLAR lock_opene_Buah editor

Outras publicacións en: RIECS: Revista de Investigación y Educación en Ciencias de la Salud

Resumo

The prognosis of HIV infection has improved with the introduction of highly active antiretroviral therapy (HAART), being no longer a contraindication to transplantation (KT). HIV-associated nephropathy (HIVAN) is the most common cause of end-stage renal disease (ESRD) among HIV-infected patients worldwide. The consensus criteria for the selection of HIV patients for transplantation are multidisciplinary: no opportunistic infections; CD4 count >200; undetectable viral load. Material and methods. Review of the clinical charts of 14 HIV-infected, recipients of a primary renal allograft (2001-2019). Inclusion criteria met the American and Spanish guideline recommendations. Immunosuppressive protocol followed routine practice in our country. HAART was started during immediate post-KT. Results. The main ESRD etiology was glomerulonephritis (6; 42.9%) followed by HIVAN (4; 28.6%). Regarding renal substitutive treatment prior to KT, the majority were on hemodialysis (10; 71.4%). In one patient KT was pre-emptive. Median CD4 count was 458 cells/µL and all patients presented undetectable viral load. 13 (92.9%) were on HAART prior to KT. Two patients underwent early transplantectomy, the remaining patients were followed for a median of 61.0 months (3.7 to 106.2 months). Delayed graft function and acute rejection rate were 58.3% (7/12) and 33.3% (4/12) respectively. Median creatinine levels at 3 months and at the last follow-up were 1.3 mg/dL (IQR 0.8) and 2.1 mg/dL (IQR 7.1) respectively. Graft and patient survival at 1 and 3 years were respectively 75.0% and 100%; and 67.0% and 89%. Conclusions. KT can be safe and effective in selected HIV-infected patients

Fonte de datos: Dialnet