HOPE in action: A prospective multicenter pilot study of liver transplantation from donors with HIV to recipients with HIV. Issue 3 (25th November 2021)

• Record Type: Journal Article
• Authors: Durand, Christine M.; Florman, Sander; Motter, Jennifer D.; Brown, Diane; Ostrander, Darin; Yu, Sile; Liang, Tao; Werbel, William A.; Cameron, Andrew; Ottmann, Shane; Hamilton, James P.; Redd, Andrew D.; Bowring, Mary G.; Eby, Yolanda; Fernandez, Reinaldo E.; Doby, Brianna; Labo, Nazzarena; Whitby, Denise; Miley, Wendell; Friedman‐Moraco, Rachel; Turgeon, Nicole; Price, Jennifer C.; Chin‐Hong, Peter; Stock, Peter; Stosor, Valentina; Kirchner, Varvara A.; Pruett, Timothy; Wojciechowski, David; Elias, Nahel; Wolfe, Cameron; Quinn, Thomas C.; Odim, Jonah; Morsheimer, Megan; Mehta, Sapna A.; Rana, Meenakshi M.; Huprikar, Shirish; Massie, Allan; Tobian, Aaron A. R.; Segev, Dorry L.;
• Other Names: Pereira Marcus investigator.; Piquant Dominique investigator.; Edwards Carolyn investigator.; Ranganna Karthik M investigator.; Link Katherine investigator.; Pearson Thomas investigator.; Mehta Aneesh K investigator.; Lyon G. Marshall investigator.; Kitchens William investigator.; Huckaby Jeryl investigator.; Elbein Rivka investigator.; Roberson April investigator.; Ferry Elizabeth investigator.; Adebiyi Margaret investigator.; Adebiyi Oluwafisayo investigator.; Kubal Chandrahekhar investigator.; Ambinder Richard investigator.; Barnaba Brittany investigator.; Bismut Gilad investigator.; Bollinger Juli investigator.; Boyarsky Brian investigator.; Charles Curtisha investigator.; Cochran Willa V investigator.; Desai Niraj N investigator.; Doby Brianna investigator.; Johnstone Jaylyn investigator.; Kirby Charles investigator.; Klock Ethan investigator.; Kusemiju Oyinkansola investigator.; Miller Jernelle investigator.; Morrison Michelle investigator.; Prizzi Michelle investigator.; Schmidt Haley investigator.; Rasmussen Sarah investigator.; Sugarman Jeremy investigator.; Seaman Shanti investigator.; Thomas Margret investigator.; Akhran Aleya investigator.; Coakley Margaret investigator.; Cooper Matthew investigator.; Gilbert Alexander investigator.; Stucke Alyssa investigator.; Timpone Joseph investigator.; Castillo‐Lugo Jose A investigator.; Townsend Melba investigator.; Haydel Brandy M. investigator.; Goudy Leah investigator.; Gallon Lorenzo investigator.; Dieter Rebecca investigator.; Deterville Cecilia investigator.; Klein Elizabeth investigator.; Neumann Henry investigator.; Weldon Elaina P investigator.; Hand Jonathan investigator.; Smith Angela R investigator.; Blumberg Emily A investigator.; Donaghy Eileen investigator.; Dunn Ty investigator.; Sawinski Deirdre investigator.; Mall Mark investigator.; Santos Carlos A. Q investigator.; Basinger Katherine investigator.; Locke Jayme E investigator.; Mehta Shikha investigator.; Mompoint‐Williams Darnell investigator.; Gadzhyan Janette investigator.; Schaenman Joanna investigator.; Aslam Saima investigator.; Mekeel Kristin investigator.; Nguyen Phirum investigator.; Chao Ada investigator.; Kwan Joanne investigator.; Rogers Rodney investigator.; Srisengf Tab investigator.; Apewokin Senu investigator.; Harrison Kathleen investigator.; Kramer Samantha investigator.; Wilkinson Rachel investigator.; Benamu Esther investigator.; Spaggiari Mario investigator.; Bruno Kelly investigator.; Brogden Gregory investigator.; Husson Jennifer investigator.; Jeffery Alicia investigator.; Marrazzo Ilise D investigator.; Morris Michele I investigator.; Munoz Carlos investigator.; Simkins Jacques investigator.; Farnsworth Mary investigator.; Haidar Ghady investigator.; Hughes Kramer Kailey investigator.; Pakstis Diana Lynn investigator.; Silveira Fernanda investigator.; Baah Whitney investigator.; Carlson Emily investigator.; La Hoz Ricardo M investigator.; Agarwal Avinash investigator.; Doyle Alden investigator.; Nagy Jamie investigator.; Baldecchi Mary investigator.; Brigle Nathaniel investigator.; Gupta Gaurav investigator.; Butkus‐Small Catherine investigator.; Muthukumar Thangamani investigator.; Malinis Maricar investigator.; Tomlin Ricarda investigator.;
• Is Part Of: American journal of transplantation. Volume 22:Issue 3(2022)
• Page Start: 853
• Page End: 864
• Publication Date: 2021-11-25
• Subjects: clinical research/practice -- ethics and public policy -- infection and infectious agents ‐ viral: hepatitis C -- infection and infectious agents ‐ viral: human herpesvirus 8 (HHV‐8) -- infection and infectious agents ‐ viral: human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) -- infectious disease -- liver disease -- liver disease: infectious -- liver transplantation/hepatology; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.16886
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : Liver transplantation (LT) from donors‐with‐HIV to recipients‐with‐HIV (HIV D+/R+) is permitted under the HOPE Act. There are only three international single‐case reports of HIV D+/R+ LT, each with limited follow‐up. We performed a prospective multicenter pilot study comparing HIV D+/R+ to donors‐without‐HIV to recipients‐with‐HIV (HIV D−/R+) LT. We quantified patient survival, graft survival, rejection, serious adverse events (SAEs), human immunodeficiency virus (HIV) breakthrough, infections, and malignancies, using Cox and negative binomial regression with inverse probability of treatment weighting. Between March 2016–July 2019, there were 45 LTs (8 simultaneous liver‐kidney) at 9 centers: 24 HIV D+/R+, 21 HIV D−/R+ (10 D− were false‐positive). The median follow‐up time was 23 months. Median recipient CD4 was 287 cells/µL with 100% on antiretroviral therapy; 56% were hepatitis C virus (HCV)‐seropositive, 13% HCV‐viremic. Weighted 1‐year survival was 83.3% versus 100.0% in D+ versus D− groups ( p = .04). There were no differences in one‐year graft survival (96.0% vs. 100.0%), rejection (10.8% vs. 18.2%), HIV breakthrough (8% vs. 10%), or SAEs (all p > .05). HIV D+/R+ had more opportunistic infections, infectious hospitalizations, and cancer. In this multicenter pilot study of HIV D+/R+ LT, patient and graft survival were better than historical cohorts, however, a potential increase in infections and cancer merits further investigation. Abstract : A multicenter study of HIV+ donor to HIV+ recipient liver transplantation under the HOPE Act shows that patient and graft survival were better than historical cohorts, but the possible increased incidence of infections and cancer merits further investigation.