Outcomes of Renal Transplantation in HIV-1 Associated Nephropathy |
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Authors: | Sana Waheed Ahmad Sakr Neha D. Chheda Gregory M. Lucas Michelle Estrella Derek M. Fine Mohamed G. Atta |
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Affiliation: | 1. Medicine, University of Wisconsin School of Medicine, Madison, Wisconsin, United States of America.; 2. Ain Shams Faculty of Medicine, Cairo, Egypt.; 3. Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America.; University of North Texas Health Science Center, UNITED STATES, |
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Abstract: | IntroductionSeveral studies have demonstrated that renal transplantation in HIV positive patients is both safe and effective. However, none of these studies have specifically examined outcomes in patients with HIV-associated nephropathy (HIVAN).MethodsMedical records of all HIV-infected patients who underwent kidney transplantation at Johns Hopkins Hospital between September 2006 and January 2014 were reviewed. Data was collected to examine baseline characteristics and outcomes of transplant recipients with HIVAN defined pathologically as collapsing focal segmental glomerulosclerosis (FSGS) with tubulo-interstitial disease.Results and DiscussionDuring the study period, a total of 16 patients with HIV infection underwent renal transplantation. Of those, 11 patients were identified to have biopsy-proven HIVAN as the primary cause of their end stage renal disease (ESRD) and were included in this study. They were predominantly African American males with a mean age of 47.6 years. Seven (64%) patients developed delayed graft function (DGF), and 6 (54%) patients required post-operative dialysis within one week of transplant. Graft survival rates at 1 and 3 years were 100% and 81%, respectively. Acute rejection rates at 1 and 3 years were 18% and 27%, respectively. During a mean follow up of 3.4 years, one patient died.ConclusionsAcute rejection rates in HIVAN patients in this study are higher than reported in the general ESRD population, which is similar to findings from prior studies of patients with HIV infection and ESRD of various causes. The high rejection rates appear to have no impact on short or intermediate term graft survival. |
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