Outcomes of renal transplantation in HIV-1 associated nephropathy

Sana Waheed, Ahmad Sakr, Neha D. Chheda, Gregory M Lucas, Michelle Estrella, Derek M Fine, Mohamed Atta

Research output: Contribution to journalArticle

Abstract

Introduction: Several studies have demonstrated that renal transplantation in HIV positive patients is both safe and effective. However, none of these studies have specifically examined outcomes in patients with HIV-associated nephropathy (HIVAN). Methods: Medical records of all HIV-infected patients who underwent kidney transplantation at Johns Hopkins Hospital between September 2006 and January 2014 were reviewed. Data was collected to examine baseline characteristics and outcomes of transplant recipients with HIVAN defined pathologically as collapsing focal segmental glomerulosclerosis (FSGS) with tubulo-interstitial disease. Results and Discussion: During the study period, a total of 16 patients with HIV infection underwent renal transplantation. Of those, 11 patients were identified to have biopsy-proven HIVAN as the primary cause of their end stage renal disease (ESRD) and were included in this study. They were predominantly African American males with a mean age of 47.6 years. Seven (64%) patients developed delayed graft function (DGF), and 6 (54%) patients required post-operative dialysis within one week of transplant. Graft survival rates at 1 and 3 years were 100% and 81%, respectively. Acute rejection rates at 1 and 3 years were 18% and 27%, respectively. During a mean follow up of 3.4 years, one patient died. Conclusions: Acute rejection rates in HIVAN patients in this study are higher than reported in the general ESRD population, which is similar to findings from prior studies of patients with HIV infection and ESRD of various causes. The high rejection rates appear to have no impact on short or intermediate term graft survival.

Original languageEnglish (US)
Article numbere0129702
JournalPLoS One
Volume10
Issue number6
DOIs
StatePublished - Jun 10 2015

Fingerprint

AIDS-Associated Nephropathy
kidney transplant
Human immunodeficiency virus 1
kidney diseases
Kidney Transplantation
HIV-1
Grafts
Transplants
Dialysis
Biopsy
Chronic Kidney Failure
HIV infections
Graft Survival
HIV Infections
HIV
Delayed Graft Function
Focal Segmental Glomerulosclerosis
African Americans
dialysis
Medical Records

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Outcomes of renal transplantation in HIV-1 associated nephropathy. / Waheed, Sana; Sakr, Ahmad; Chheda, Neha D.; Lucas, Gregory M; Estrella, Michelle; Fine, Derek M; Atta, Mohamed.

In: PLoS One, Vol. 10, No. 6, e0129702, 10.06.2015.

Research output: Contribution to journalArticle

Waheed, Sana ; Sakr, Ahmad ; Chheda, Neha D. ; Lucas, Gregory M ; Estrella, Michelle ; Fine, Derek M ; Atta, Mohamed. / Outcomes of renal transplantation in HIV-1 associated nephropathy. In: PLoS One. 2015 ; Vol. 10, No. 6.
@article{57c2ac56412c492bb42085b3ef4e68b7,
title = "Outcomes of renal transplantation in HIV-1 associated nephropathy",
abstract = "Introduction: Several studies have demonstrated that renal transplantation in HIV positive patients is both safe and effective. However, none of these studies have specifically examined outcomes in patients with HIV-associated nephropathy (HIVAN). Methods: Medical records of all HIV-infected patients who underwent kidney transplantation at Johns Hopkins Hospital between September 2006 and January 2014 were reviewed. Data was collected to examine baseline characteristics and outcomes of transplant recipients with HIVAN defined pathologically as collapsing focal segmental glomerulosclerosis (FSGS) with tubulo-interstitial disease. Results and Discussion: During the study period, a total of 16 patients with HIV infection underwent renal transplantation. Of those, 11 patients were identified to have biopsy-proven HIVAN as the primary cause of their end stage renal disease (ESRD) and were included in this study. They were predominantly African American males with a mean age of 47.6 years. Seven (64{\%}) patients developed delayed graft function (DGF), and 6 (54{\%}) patients required post-operative dialysis within one week of transplant. Graft survival rates at 1 and 3 years were 100{\%} and 81{\%}, respectively. Acute rejection rates at 1 and 3 years were 18{\%} and 27{\%}, respectively. During a mean follow up of 3.4 years, one patient died. Conclusions: Acute rejection rates in HIVAN patients in this study are higher than reported in the general ESRD population, which is similar to findings from prior studies of patients with HIV infection and ESRD of various causes. The high rejection rates appear to have no impact on short or intermediate term graft survival.",
author = "Sana Waheed and Ahmad Sakr and Chheda, {Neha D.} and Lucas, {Gregory M} and Michelle Estrella and Fine, {Derek M} and Mohamed Atta",
year = "2015",
month = "6",
day = "10",
doi = "10.1371/journal.pone.0129702",
language = "English (US)",
volume = "10",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "6",

}

TY - JOUR

T1 - Outcomes of renal transplantation in HIV-1 associated nephropathy

AU - Waheed, Sana

AU - Sakr, Ahmad

AU - Chheda, Neha D.

AU - Lucas, Gregory M

AU - Estrella, Michelle

AU - Fine, Derek M

AU - Atta, Mohamed

PY - 2015/6/10

Y1 - 2015/6/10

N2 - Introduction: Several studies have demonstrated that renal transplantation in HIV positive patients is both safe and effective. However, none of these studies have specifically examined outcomes in patients with HIV-associated nephropathy (HIVAN). Methods: Medical records of all HIV-infected patients who underwent kidney transplantation at Johns Hopkins Hospital between September 2006 and January 2014 were reviewed. Data was collected to examine baseline characteristics and outcomes of transplant recipients with HIVAN defined pathologically as collapsing focal segmental glomerulosclerosis (FSGS) with tubulo-interstitial disease. Results and Discussion: During the study period, a total of 16 patients with HIV infection underwent renal transplantation. Of those, 11 patients were identified to have biopsy-proven HIVAN as the primary cause of their end stage renal disease (ESRD) and were included in this study. They were predominantly African American males with a mean age of 47.6 years. Seven (64%) patients developed delayed graft function (DGF), and 6 (54%) patients required post-operative dialysis within one week of transplant. Graft survival rates at 1 and 3 years were 100% and 81%, respectively. Acute rejection rates at 1 and 3 years were 18% and 27%, respectively. During a mean follow up of 3.4 years, one patient died. Conclusions: Acute rejection rates in HIVAN patients in this study are higher than reported in the general ESRD population, which is similar to findings from prior studies of patients with HIV infection and ESRD of various causes. The high rejection rates appear to have no impact on short or intermediate term graft survival.

AB - Introduction: Several studies have demonstrated that renal transplantation in HIV positive patients is both safe and effective. However, none of these studies have specifically examined outcomes in patients with HIV-associated nephropathy (HIVAN). Methods: Medical records of all HIV-infected patients who underwent kidney transplantation at Johns Hopkins Hospital between September 2006 and January 2014 were reviewed. Data was collected to examine baseline characteristics and outcomes of transplant recipients with HIVAN defined pathologically as collapsing focal segmental glomerulosclerosis (FSGS) with tubulo-interstitial disease. Results and Discussion: During the study period, a total of 16 patients with HIV infection underwent renal transplantation. Of those, 11 patients were identified to have biopsy-proven HIVAN as the primary cause of their end stage renal disease (ESRD) and were included in this study. They were predominantly African American males with a mean age of 47.6 years. Seven (64%) patients developed delayed graft function (DGF), and 6 (54%) patients required post-operative dialysis within one week of transplant. Graft survival rates at 1 and 3 years were 100% and 81%, respectively. Acute rejection rates at 1 and 3 years were 18% and 27%, respectively. During a mean follow up of 3.4 years, one patient died. Conclusions: Acute rejection rates in HIVAN patients in this study are higher than reported in the general ESRD population, which is similar to findings from prior studies of patients with HIV infection and ESRD of various causes. The high rejection rates appear to have no impact on short or intermediate term graft survival.

UR - http://www.scopus.com/inward/record.url?scp=84936863810&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84936863810&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0129702

DO - 10.1371/journal.pone.0129702

M3 - Article

C2 - 26061701

AN - SCOPUS:84936863810

VL - 10

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 6

M1 - e0129702

ER -