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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Miro, J. M. Ricart, M. J. Trullas, J. C. Cofan, F. Cervera, C. Brunet, M. Tuset, M. Manzardo, C. Oppenheimer, F. Moreno, A. |
| Description | Country affiliation: Spain Author Affiliation: Miro JM ( Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain. jmmiro@ub.edu) |
| Abstract | Since the introduction of combined antiretroviral therapy (cART), solid organ transplantation (SOT) has become a therapeutic option for the HIV-positive population. In contrast with liver and kidney transplantation, only three simultaneous pancreas-kidney transplants (SPKT) have been reported among HIV-infected patients. Herein we have reported the first SPKT in an HIV-infected patient in Spain. The pancreas graft failed at 2 weeks and the patient died at 9 months because of a Pseudomonas aeruginosa infection. The three recipients reported in the literature lived, despite the failure of both the pancreas and kidney grafts in one subject. Despite the poor outcome of our case, HIV-1 infection was controlled after transplantation (stable CD4(+) cells and no AIDS-related events), and the kidney graft functioned with no episodes of rejection. The cART regimen used in the pretransplant period was switched at the time of transplantation to raltegravir and two nucleoside reverse transcriptase inhibitors (NRTI). Raltegravir has no interactions with immunosuppressive drugs. Target plasma levels of tacrolimus were achieved at a dose similar to that used in HIV-negative transplant recipients. The most adequate antiretroviral regimen for HIV-infected SOT recipients has not yet been established; however, one may consider switching protease inhibitors or non-NRTI-based regimens for a raltegravir-based regimen at the time of transplantation. |
| File Format | HTM / HTML |
| ISSN | 00411345 |
| Issue Number | 9 |
| Volume Number | 42 |
| e-ISSN | 18732623 |
| Journal | Transplantation Proceedings |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2010-11-01 |
| Publisher Place | United States |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Transplantation__semicolon__medicine Anti-retroviral Agents Therapeutic Use Hiv Infections Drug Therapy Immunosuppressive Agents Kidney Transplantation Pancreas Transplantation Adult Adverse Effects Antiretroviral Therapy, Highly Active Fatal Outcome Graft Rejection Etiology Graft Survival Complications Virology Hiv-1 Pathogenicity Humans Male Pseudomonas Infections Microbiology Pseudomonas Aeruginosa Time Factors Treatment Outcome Case Reports Journal Article Research Support, Non-u.s. Gov't Review |
| Content Type | Text |
| Resource Type | Article Case study |
| Subject | Transplantation Surgery |
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