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Adverse Outcomes Up With Kidney Retransplant in HIV+

HIV+ retransplant recipients have increased risk of death and graft loss versus HIV− re-KT patients

THURSDAY, June 23, 2016 (HealthDay News) — Primary HIV+ kidney transplant recipients who lose their graft and seek retransplantation (re-KT) have an increased risk of death and graft loss, according to a study published online June 15 in the American Journal of Transplantation.

Brittany A. Shelton, M.P.H., from the University of Alabama at Birmingham Comprehensive Transplant Institute, and colleagues studied the risk of death and graft loss among 4,149 (22 HIV+ and 4,127 HIV−) adult re-KT recipients.

The researchers found that HIV+ re-KT patients were more often African-American, infected with hepatitis C, and had longer median time on dialysis, compared with HIV− re-KT patients. The length of time between the primary and re-KT events did not differ significantly based on HIV status (1.5 and 1.4 years for HIV+ and HIV−, respectively; P = 0.52). Compared with HIV− re-KT recipients, HIV+ re-KT recipients had an elevated risk of death and graft loss (adjusted hazard ratios, 3.11 and 1.96, respectively).

“Re-KT among HIV+ recipients was associated with increased risk for mortality and graft loss,” the authors write. “Future research is needed to determine if a survival benefit is achieved with re-KT in this vulnerable population.”

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