The Times, They are a-Changing: HOPE for HIV-to-HIV Organ Transplantation.
Identifieur interne : 000157 ( Main/Exploration ); précédent : 000156; suivant : 000158The Times, They are a-Changing: HOPE for HIV-to-HIV Organ Transplantation.
Auteurs : Ghady Haidar [États-Unis] ; Nina SinghSource :
- Transplantation [ 1534-6080 ] ; 2017.
Descripteurs français
- KwdFr :
- Agents antiVIH (usage thérapeutique), Donneurs de tissus (ressources et distribution), Facteurs de risque, Génotype, Humains, Infections à VIH (), Infections à VIH (traitement médicamenteux), Infections à VIH (transmission), Infections à VIH (virologie), Rejet du greffon (), Rejet du greffon (immunologie), Résultat thérapeutique, Survie du greffon, Sélection de donneurs, Sélection de patients, Transplantation d'organe (), Transplantation d'organe (effets indésirables), VIH (Virus de l'Immunodéficience Humaine) (), VIH (Virus de l'Immunodéficience Humaine) (génétique), VIH (Virus de l'Immunodéficience Humaine) (pathogénicité), Évaluation des risques.
- MESH :
- effets indésirables : Transplantation d'organe.
- génétique : VIH (Virus de l'Immunodéficience Humaine).
- immunologie : Rejet du greffon.
- pathogénicité : VIH (Virus de l'Immunodéficience Humaine).
- ressources et distribution : Donneurs de tissus.
- traitement médicamenteux : Infections à VIH.
- usage thérapeutique : Agents antiVIH, Infections à VIH.
- virologie : Infections à VIH.
- Facteurs de risque, Génotype, Humains, Infections à VIH, Rejet du greffon, Résultat thérapeutique, Survie du greffon, Sélection de donneurs, Sélection de patients, Transplantation d'organe, VIH (Virus de l'Immunodéficience Humaine), Évaluation des risques.
English descriptors
- KwdEn :
- Anti-HIV Agents (therapeutic use), Donor Selection, Genotype, Graft Rejection (immunology), Graft Rejection (prevention & control), Graft Survival, HIV (drug effects), HIV (genetics), HIV (pathogenicity), HIV Infections (complications), HIV Infections (drug therapy), HIV Infections (transmission), HIV Infections (virology), Humans, Organ Transplantation (adverse effects), Organ Transplantation (methods), Patient Selection, Risk Assessment, Risk Factors, Tissue Donors (supply & distribution), Treatment Outcome.
- MESH :
- chemical , therapeutic use : Anti-HIV Agents.
- adverse effects : Organ Transplantation.
- complications : HIV Infections.
- drug effects : HIV.
- drug therapy : HIV Infections.
- genetics : HIV.
- immunology : Graft Rejection.
- methods : Organ Transplantation.
- pathogenicity : HIV.
- prevention & control : Graft Rejection.
- supply & distribution : Tissue Donors.
- transmission : HIV Infections.
- virology : HIV Infections.
- Donor Selection, Genotype, Graft Survival, Humans, Patient Selection, Risk Assessment, Risk Factors, Treatment Outcome.
Abstract
HIV-infected persons who achieve undetectable viral loads on antiretroviral therapy currently have near-normal lifespans. Liver disease is a major cause of non-AIDS-related deaths, and as a result of longer survival, the prevalence of end-stage renal disease in HIV is increasing. HIV-infected persons undergoing organ transplantation generally achieve comparable patient and graft survival rates compared to their HIV-uninfected counterparts, despite a nearly threefold increased risk of acute rejection. However, the ongoing shortage of suitable organs can limit transplantation as an option, and patients with HIV have higher waitlist mortality than others. One way to solve this problem would be to expand the donor pool to include HIV-infected individuals. The results of a South Africa study involving 27 HIV-to-HIV kidney transplants showed promise, with 3- and 5-year patient and graft survival rates similar to those of their HIV-uninfected counterparts. Similarly, individual cases of HIV-to-HIV liver transplantation from the United Kingdom and Switzerland have also shown good results. In the United States, HIV-to-HIV kidney and liver transplants are currently permitted only under a research protocol. Nevertheless, areas of ambiguity exist, including streamlining organ allocation practices, optimizing HIV-infected donor and recipient selection, managing donor-derived transmission of a resistant HIV strain, determining optimal immunosuppressive and antiretroviral regimens, and elucidating the incidence of rejection in HIV-to-HIV solid organ transplant recipients.
DOI: 10.1097/TP.0000000000001728
PubMed: 28288014
Affiliations:
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Le document en format XML
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Humaine)</term><term>Évaluation des risques</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">HIV-infected persons who achieve undetectable viral loads on antiretroviral therapy currently have near-normal lifespans. Liver disease is a major cause of non-AIDS-related deaths, and as a result of longer survival, the prevalence of end-stage renal disease in HIV is increasing. HIV-infected persons undergoing organ transplantation generally achieve comparable patient and graft survival rates compared to their HIV-uninfected counterparts, despite a nearly threefold increased risk of acute rejection. However, the ongoing shortage of suitable organs can limit transplantation as an option, and patients with HIV have higher waitlist mortality than others. One way to solve this problem would be to expand the donor pool to include HIV-infected individuals. The results of a South Africa study involving 27 HIV-to-HIV kidney transplants showed promise, with 3- and 5-year patient and graft survival rates similar to those of their HIV-uninfected counterparts. Similarly, individual cases of HIV-to-HIV liver transplantation from the United Kingdom and Switzerland have also shown good results. In the United States, HIV-to-HIV kidney and liver transplants are currently permitted only under a research protocol. Nevertheless, areas of ambiguity exist, including streamlining organ allocation practices, optimizing HIV-infected donor and recipient selection, managing donor-derived transmission of a resistant HIV strain, determining optimal immunosuppressive and antiretroviral regimens, and elucidating the incidence of rejection in HIV-to-HIV solid organ transplant recipients.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Pennsylvanie</li></region></list><tree><noCountry><name sortKey="Singh, Nina" sort="Singh, Nina" uniqKey="Singh N" first="Nina" last="Singh">Nina Singh</name></noCountry><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Haidar, Ghady" sort="Haidar, Ghady" uniqKey="Haidar G" first="Ghady" last="Haidar">Ghady Haidar</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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