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AIDS Res Treat. 2012; 2012: 197501.
Published online Jul 30, 2012. doi:  10.1155/2012/197501
PMCID: PMC3413997
Orthotopic Liver Transplantation in Human-Immunodeficiency-Virus-Positive Patients in Germany
E. Anadol, 1 * S. Beckebaum, 2 K. Radecke, 2 A. Paul, 3 A. Zoufaly, 4 M. Bickel, 5 F. Hitzenbichler, 6 T. Ganten, 7 J. Kittner, 8 M. Stoll, 9 C. Berg, 10 S. Manekeller, 11 J. C. Kalff, 11 T. Sauerbruch, 1 J. K. Rockstroh, 1 and U. Spengler 1
1Department of Internal Medicine I, University of Bonn, 53105 Bonn, Germany
2Department of General, Visceral and Transplantation Medicine, University Hospital Essen, 45122 Essen, Germany
3Department of General, Visceral and Transplantation Surgery, University Hospital Essen, 45122 Essen, Germany
4Department of Internal Medicine, University of Hamburg, 20251 Hamburg, Germany
5Department of Internal Medicine, Frankfurt University, Hospital Medical Centre, 60590 Frankfurt, Germany
6Department of Internal Medicine I, University of Regensburg, 93042 Regensburg, Germany
7Department of Internal Medicine, Heidelberg University, 69125 Heidelberg, Germany
8Department of Internal Medicine, Mainz University, 55122 Mainz, Germany
9Department of Immunology and Rheumatology, Medical University of Hannover, 30625 Hannover, Germany
10Department of Internal Medicine, Tübingen University Medical School, 72076 Tübingen, Germany
11Department of Surgery, University of Bonn, 53105 Bonn, Germany
*E. Anadol: evrim.anadol/at/ukb.uni-bonn.de
Academic Editor: Raffaele Bruno
Received January 11, 2012; Accepted May 9, 2012.
Abstract
Objectives. This summary evaluates the outcomes of orthotopic liver transplantation (OLT) of HIV-positive patients in Germany. Methods. Retrospective chart analysis of HIV-positive patients, who had been liver-transplanted in Germany between July 1997 and July 2011. Results. 38 transplantations were performed in 32 patients at 9 German transplant centres. The reasons for OLT were end-stage liver disease (ESLD) and/or liver failure due to hepatitis C (HCV) (n = 19), hepatitis B (HBV) (n = 10), multiple viral infections of the liver (n = 2) and Budd-Chiari-Syndrome. In July 2011 19/32 (60%) of the transplanted patients were still alive with a median survival of 61 months (IQR (interquartile range): 41–86 months). 6 patients had died in the early post-transplantation period from septicaemia (n = 4), primary graft dysfunction (n = 1), and intrathoracal hemorrhage (n = 1). Later on 7 patients had died from septicaemia (n = 2), delayed graft failure (n = 2), recurrent HCC (n = 2), and renal failure (n = 1). Recurrent HBV infection was efficiently prevented in 11/12 patients; HCV reinfection occurred in all patients and contributed considerably to the overall mortality. Conclusions. Overall OLT is a feasible approach in HIV-infected patients with acceptable survival rates in Germany. Reinfection with HCV still remains a major clinical challenge in HIV/HCV coinfection after OLT.
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