Transplantation in HIV-positive patients

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Transplantation in HIV-positive patients

Slide Presentation
November 30, 2005
Michelle Roland, MD
Laurie Carlson, RN, MSN

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Slide 1.

Overview

Slide 1.

Evolution of the Issues

Slide 2.

Kidney Study 1

Slide 3.

Kidney Study 2

Slide 4.

Kidney Study 2: Results

Slide 5.

Liver Study 1

Slide 6.

HCV in HIV+ and Negative Recipients

Slide 7.

HCV in HIV+ and Negative Recipients

Slide 8.

Kidney & Liver Study 1

Slide 9.

Deaths

Slide 10.

Opportunistic Complications

Slide 11.

Results: Outcomes

Slide 12.

Outcomes: Ineligible Subjects

Slide 13.

Conclusions

Slide 14.

Kidney & Liver Study 2

Slide 15.

Table 1. Baseline Characteristics of HIV-Infected Transplant Recipients

Slide 16.

Patient Survival

Slide 17.

Cause of Death

Slide 18.

Graft Survival

Slide 19.

Graft Loss (Censored for death)

Slide 20.

Table 2. Patient and Graft Survival in HIV-Infected Study Subjects and in the Organ Procurement and Transplantation Network (OPTN) Database

Slide 21.

HIV Disease Progression Post-TX

Slide 22.

Allograft Rejection

Slide 23.

Kidney Function

Slide 24.

Acute rejection

Slide 25.

Conclusions

Slide 26.

Drug Interactions

Slide 27.

Drug Interactions

Slide 28.

Changes in CsA clearance over time in patients using PIs vs NNRTIs

Slide 29.

Consquences of Rejection (N=20 kidney)

Slide 30.

CD4 Counts in HIV-infected Kidney Recipients

Slide 31.

Infections

Slide 32.

Multi-Disciplinary Health Care Team

Slide 33.

Pretransplant Survival Is Shorter in HIV-Positive Than HIV-Negative Subjects With End-Stage Liver Disease

Slide 34.

HIV Solid Organ Transplant Mult-Site Study

Slide 35.

Participating Centers: Solid Organ Transplantation in HIV: Multi-Site Study

Slide 36.

The Experience

Slide 37.

Criteria for Transplant

Slide 38.

Referral for Kidney Transplant

Slide 39.

Referral for Liver Transplant

Slide 40.

MELD Score

Slide 41.

Kidney Evaluation: Initial Process

Slide 42.

Liver Evaluation: Initial Process

Slide 43.

Medical Workup

Slide 44.

Psychosocial, Financial, & Social Support Evaluation

Slide 45.

Organ Allocation

Slide 46.

Pre Transplant Challenges

Slide 47.

Factors that Influence Waiting Time

Slide 48.

The Waiting...

Slide 49.

Reality

Slide 50.

Post Transplant Challenges

Slide 51.

Challenge: Physical Complications

Slide 52.

Challenge: Clinical Trial

Slide 53.

Challenge: Psychiatric

Slide 54.

Conclusion

Slide 55.