Outcome after orthotopic liver transplantation in five HIV-infected patients with virus hepatitis-induced cirrhosis
Article first published online: 7 FEB 2005
Volume 25, Issue 1, pages 101–108, February 2005
How to Cite
Radecke, K., Frühauf, N. R., Miller, M., Ross, B., Köditz, R., Malagó, M., Broelsch, C. E., Gerken, G. and Treichel, U. (2005), Outcome after orthotopic liver transplantation in five HIV-infected patients with virus hepatitis-induced cirrhosis. Liver International, 25: 101–108. doi: 10.1111/j.1478-3231.2005.01031.x
- Issue published online: 7 FEB 2005
- Article first published online: 7 FEB 2005
- Received 8 January 2003, accepted 14 June 2004
- end-stage liver disease;
- HIV infection;
- HIV/HBV co-infection;
- HIV/HCV co-infection;
- liver transplantation
Abstract: Background: We report on our experiences with orthotopic liver transplantation (OLT) in HIV-infected patients. Between July 1998 and October 2001, five HIV-infected patients underwent OLT because of virus-induced liver cirrhosis. One patient suffered from hepatitis B virus (HBV)-, three patients from hepatitis C virus (HCV)- and one patient from HCV/HBV/HDV-related cirrhosis (HDV, hepatitis D virus). The mean duration of HIV infection was 15 years. Patients were prospectively followed up with a mean duration of 25.6 months.
Results: Three patients died 3, 10 and 31 months after OLT, respectively, due to graft failure. The causes of graft failure were: recurrent thrombosis of the hepatic artery, HCV-associated cholestatic hepatitis and chemotherapy-induced liver damage due to Hodgkin's disease, which was diagnosed 17 months after OLT, in addition to chronic HCV disease. The two survivors show a stable liver function and non-progredient HIV infection under antiretroviral therapy 61 and 23 months after OLT, respectively.
Conclusions: A medium- or even long-term survival after OLT can be achieved in HIV-infected patients without progression of HIV disease under antiretroviral therapy. However, in our study three out of five patients died due to graft failure. Therefore, prognostic criteria have to be defined for the selection of HIV-infected patients, who may benefit from OLT.