D. K. Agarwal
Indraprastha Apollo hospitals, India
Title: Renal Transplantation in HIV positive patients; Our experience at Indraprastha Apollo Hospitals, New Delhi, India
Biography
Biography: D. K. Agarwal
Abstract
HIV infection is a major health problem worldwide. These patients are at high risk for end stage renal disease because of multiple factors including HIVAN. Previously HIV infection was considered a contraindication to renal transplantation. However with gaining experience, renal transplantation has been proved to be a safe and effective mode of treatment. Various studies have also confirmed that patient and graft survival are at par with results of renal transplantation in non HIV recipients. We conducted a prospective observational study of renal transplant in HIV recipients at our center. We did 20 renal transplants in HIV positive patients from 2009 to 2017 successfully. HIV RNA negativity C04 count more than 200 and absence of opportunistic infections were eligibility criteria. HTN (60%) was the most common cause of end stage renal disease followed by HIVAN and diabetic Nephropathy. Most of the patients were male (18 out of 20). 17 (85%) patients were on hemodialysis before transplant. All patients had received renal allograft from live donors. All patients were put on triple drug immunosuppression including steroids, MMF and CNI in the form of tacrolimus or cyclosporine along with cART. The patient and graft survival were 93% each at one year, 93% and 79% at 3 years and 93% and 79% at 5 years respectively. The major complications were infections (30%), NODAT (20%), CNI toxicity (15%) and acute rejection (10%). There was no relapse of HIV in our cases except in one case with very low viral copies.