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AIDS Res Treat. 2012;2012:197501. doi: 10.1155/2012/197501. Epub 2012 Jul 30.

Orthotopic liver transplantation in human-immunodeficiency-virus-positive patients in Germany.

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1
Department of Internal Medicine I, University of Bonn, 53105 Bonn, Germany.

Abstract

OBJECTIVES:

This summary evaluates the outcomes of orthotopic liver transplantation (OLT) of HIV-positive patients in Germany.

METHODS:

Retrospective chart analysis of HIV-positive patients, who had been liver-transplanted in Germany between July 1997 and July 2011.

RESULTS:

38 transplantations were performed in 32 patients at 9 German transplant centres. The reasons for OLT were end-stage liver disease (ESLD) and/or liver failure due to hepatitis C (HCV) (n = 19), hepatitis B (HBV) (n = 10), multiple viral infections of the liver (n = 2) and Budd-Chiari-Syndrome. In July 2011 19/32 (60%) of the transplanted patients were still alive with a median survival of 61 months (IQR (interquartile range): 41-86 months). 6 patients had died in the early post-transplantation period from septicaemia (n = 4), primary graft dysfunction (n = 1), and intrathoracal hemorrhage (n = 1). Later on 7 patients had died from septicaemia (n = 2), delayed graft failure (n = 2), recurrent HCC (n = 2), and renal failure (n = 1). Recurrent HBV infection was efficiently prevented in 11/12 patients; HCV reinfection occurred in all patients and contributed considerably to the overall mortality.

CONCLUSIONS:

Overall OLT is a feasible approach in HIV-infected patients with acceptable survival rates in Germany. Reinfection with HCV still remains a major clinical challenge in HIV/HCV coinfection after OLT.

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