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Heart Transplantation Survival Outcomes of HIV Positive and Negative Recipients.

Publication ,  Journal Article
Doberne, JW; Jawitz, OK; Raman, V; Bryner, BS; Schroder, JN; Milano, CA
Published in: Ann Thorac Surg
May 2021

BACKGROUND: In the era of antiretroviral therapy, HIV-positive patients have reduced mortality from HIV infection and increased morbidity from end-stage heart failure. The number of HIV-positive heart transplantation recipients remains scant. Long-term survival has not been rigorously studied. We compared survival outcomes of heart transplantation in HIV-positive recipients with those of HIV-negative recipients. METHODS: Clinical data from all adult heart transplantations were extracted from the United Network for Organ Sharing dataset. The impact of recipient HIV status was analyzed with Cox proportional hazards modeling, 1:3 propensity score matching, and Kaplan-Meier survival analysis. RESULTS: Seventy-five HIV-positive recipients and 29,848 HIV-negative recipients were identified. Race distributions differed between the recipient groups, with black patients comprising a larger proportion of the HIV-positive recipient group (46.7% vs 20.9%, P < .001). The mean year of transplant was significantly later in the HIV-positive recipient group. The rate of acute rejection in the HIV-positive group was higher than in the HIV-negative group (38.7% vs 17.7%, P < .001), as was rate of antirejection treatment administration such as intravenous immunoglobulin or plasmapheresis (26.7% vs 10.4%, P < .001). There was no difference in 30-day, 1-year, and 5-year survival of HIV-positive recipients vs HIV-negative recipients. Recipient HIV infection was not a significant covariate in predicting survival in a Cox proportional hazards model. CONCLUSIONS: Short-term and moderate-term survival after heart transplantation is similar for HIV-positive recipients and HIV-negative recipients, although data are very limited. This finding suggests that HIV-positive recipients should not be excluded from transplant candidacy solely based on HIV serostatus.

Duke Scholars

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Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

May 2021

Volume

111

Issue

5

Start / End Page

1465 / 1471

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Middle Aged
  • Male
  • Humans
  • Heart Transplantation
  • Heart Failure
  • HIV Seropositivity
 

Citation

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Doberne, J. W., Jawitz, O. K., Raman, V., Bryner, B. S., Schroder, J. N., & Milano, C. A. (2021). Heart Transplantation Survival Outcomes of HIV Positive and Negative Recipients. Ann Thorac Surg, 111(5), 1465–1471. https://doi.org/10.1016/j.athoracsur.2020.06.120
Doberne, Julie W., Oliver K. Jawitz, Vignesh Raman, Benjamin S. Bryner, Jacob N. Schroder, and Carmelo A. Milano. “Heart Transplantation Survival Outcomes of HIV Positive and Negative Recipients.Ann Thorac Surg 111, no. 5 (May 2021): 1465–71. https://doi.org/10.1016/j.athoracsur.2020.06.120.
Doberne JW, Jawitz OK, Raman V, Bryner BS, Schroder JN, Milano CA. Heart Transplantation Survival Outcomes of HIV Positive and Negative Recipients. Ann Thorac Surg. 2021 May;111(5):1465–71.
Doberne, Julie W., et al. “Heart Transplantation Survival Outcomes of HIV Positive and Negative Recipients.Ann Thorac Surg, vol. 111, no. 5, May 2021, pp. 1465–71. Pubmed, doi:10.1016/j.athoracsur.2020.06.120.
Doberne JW, Jawitz OK, Raman V, Bryner BS, Schroder JN, Milano CA. Heart Transplantation Survival Outcomes of HIV Positive and Negative Recipients. Ann Thorac Surg. 2021 May;111(5):1465–1471.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

May 2021

Volume

111

Issue

5

Start / End Page

1465 / 1471

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Retrospective Studies
  • Respiratory System
  • Middle Aged
  • Male
  • Humans
  • Heart Transplantation
  • Heart Failure
  • HIV Seropositivity