Abstract 230 - IMPIEGO DEI GLICOPEPTIDI NELLA ... - SIMIT

97
10° CONGRESSO NAZIONALE SIMIT
Abstract 253
- KIDNEY TRANSPLANTATION IN HIV-POSITIVE RECIPIENTS UNDER HAART: A
SINGLE-COHORT EXPERIENCE (BRESCIA, NORTHERN ITALY) -
Izzo I. [1] , Casari S. [1] , Bossini N. [2] , Panzali A. [3] , Chiappini R. [4] , Carosi G.* [1]
- [1] Istituto di Malattie Infettive e Tropicali ~ Brescia - [2] Unità trapianto di rene, Spedali Civili ~ Brescia - [3] III Laboratorio
analisi, Spedali Civili ~ Brescia - [4] ASL 302, regione Lombardia ~ Brescia
INFEZIONI DA HIV
Premessa: Kidney transplantation is being introduced for the treatment of end-stage renal
disease in HIV positive patients. Herein, we report the results of the first 9 kidney
transplantation procedures in HIV-positive patients at our Institution.
Obiettivo: To evaluate viro-immunological and clinical outcome of HIV-positive patients
undergoing kidney transplantation for ESRD (end stage renal disease).
Risultati: 29 patients were evaluated from January 2005 to June 2011; among them 16
entered the list and 9 were transplanted. Induction immunosuppressive therapy consisted
of metilprednisolone and basiliximab. Tacrolimus or cyclosporine and mycofenolic acid
were used for manteinance therapy.
All patients are alive with functioning graft. Acute rejection incidence was 55% (5 of 9
patients), 1 patient developed skin Kaposi sarcoma one year after transplantation and 3
patients developed infectious diseases after transplantation.
Median CD4+ T-cell count 244,5 cell/mm3 (IQR 193-275 cell/mm3, range 193-310
cell/mm3) at first month, 335,5 cell/mm3 (IQR 253-354 cell/mm3, range 253-435
cell/mm3) at third month and 474 cell/mm3 (IQR 262-484 cell/mm3, range 247-474
cell/mm3) 1 year after transplantation.
HIV RNA was always undetectable in 4/9 patients and became undetectable within 24
weeks in the patient starting HAART at transplantation. 2 patients presented HIV RNA
blips, which promptly resolved. 2 patients had virological failure after transplantation, but
obtained HIV RNA undetectability after modification of HAART regimen. At last available
point of follow up (median 42.1 months, IQR 25.6-42.2 months) all patients had
undetectable HIV RNA.
Conclusione: Kidney transplantation appears to be safe in HIV positive patients on
HAART carefully selected.