HIV Digest	HIV Digest Archive

According to researchers, patients infected with HIV appear to do well following the receipt of donor kidneys and livers. Despite the fact that patients routinely must receive cyclosporine, an immuno-suppressant administered so that organ rejection does not occur, HIV/AIDS patients do gain from the operation. "Frankly, a lot of us thought that giving cyclosporine to these patients would be almost immediately fatal," said Dr. Lynda Frassetto, associate clinical professor of medicine at the University of California-San Francisco.

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Frassetto said that eight of her first nine transplant patients have survived the procedure, one for as long as 18 months. The patient who died was infected through blood products used to treat childhood leukemia. He received two liver transplants but died 15 months later of advanced hepatitis. Three patients received livers. Six patients received kidneys. With the exception of one teenager, adults who received organs ranged in age from 38 to 53 at the time of the operation.

Nine patients who had HIV and stable viral loads thanks to antiretroviral drugs were selected for the study. They were all treated for any other existing disease or condition before undergoing transplant. They received a transplant because they were either next in line on a transplant list, had a family member donor, or agreed to accept organs that were rejected from other institutions, usually because the donor was elderly.

In the patients receiving cyclosporine, the level of CD4 cells increased, sometimes markedly. The larger the number of CD4 cells, the greater the immune competence. "Fifteen years ago, having HIV infection was an absolute exclusion for receiving a transplant," said Dr. Solomon Smith, a nephrologist and AIDS specialist. "But now, with treatments, we have extended the life expectancy of AIDS patients so that these patients with liver and kidney failure can benefit from these transplants."

from the United Press International