%0 Journal Article
%A Agüero, F
%A Rimola, A
%A Stock, P
%A Grossi, P
%A Rockstroh, J K
%A Agarwal, K
%A Garzoni, C
%A Barcan, L A
%A Maltez, F
%A Manzardo, C
%A Mari, M
%A Ragni, M V
%A Anadol, E
%A Di Benedetto, F
%A Nishida, S
%A Gastaca, M
%A Miró, J M
%A FIPSE/NIH HIVTR/NEAT023 Investigators
%T Liver Retransplantation in Patients With HIV-1 Infection: An International Multicenter Cohort Study.
%D 2015
%U https://hdl.handle.net/10668/24509
%X Liver retransplantation is performed in HIV-infected patients, although its outcome is not well known. In an international cohort study (eight countries), 37 (6%; 32 coinfected with hepatitis C virus [HCV] and five with hepatitis B virus [HBV]) of 600 HIV-infected patients who had undergone liver transplant were retransplanted. The main indications for retransplantation were vascular complications (35%), primary graft nonfunction (22%), rejection (19%), and HCV recurrence (13%). Overall, 19 patients (51%) died after retransplantation. Survival at 1, 3, and 5 years was 56%, 51%, and 51%, respectively. Among patients with HCV coinfection, HCV RNA replication status at retransplantation was the only significant prognostic factor. Patients with undetectable versus detectable HCV RNA had a survival probability of 80% versus 39% at 1 year and 80% versus 30% at 3 and 5 years (p = 0.025). Recurrence of hepatitis C was the main cause of death in the latter. Patients with HBV coinfection had survival of 80% at 1, 3, and 5 years after retransplantation. HIV infection was adequately controlled with antiretroviral therapy. In conclusion, liver retransplantation is an acceptable option for HIV-infected patients with HBV or HCV coinfection but undetectable HCV RNA. Retransplantation in patients with HCV replication should be reassessed prospectively in the era of new direct antiviral agents.
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