TY  - BOOK
AU  - Light, Jimmy
TI  - Surgical complications in 275 HIV-infected liver and/or kidney transplantation recipients
SN  - 0039-6060
KW  - *Graft Survival
KW  - *HIV Infections/ep [Epidemiology]
KW  - *Kidney Transplantation/sn [Statistics & Numerical Data]
KW  - *Liver Transplantation/sn [Statistics & Numerical Data]
KW  - *Postoperative Complications/ep [Epidemiology]
KW  - *Surgical Wound Dehiscence/ep [Epidemiology]
KW  - *Surgical Wound Infection/ep [Epidemiology]
KW  - Anastomotic Leak/ep [Epidemiology]
KW  - HIV Infections/su [Surgery]
KW  - Humans
KW  - Intraoperative Complications/ep [Epidemiology]
KW  - Kidney Transplantation/mo [Mortality]
KW  - Liver Transplantation/mo [Mortality]
KW  - Proportional Hazards Models
KW  - Prospective Studies
KW  - Reoperation
KW  - Survival Rate
KW  - Transplantation/sn [Statistics & Numerical Data]
KW  - Viral Load
KW  - MedStar Washington Hospital Center
KW  - Surgery/Transplantation
KW  - Clinical Trial
KW  - Journal Article
KW  - Multicenter Study
KW  - Research Support, N.I.H., Extramural
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - BACKGROUND: In this report, we examine the surgical safety and complications (SC) among 125 liver (L) and 150 kidney (K) HIV+ transplantation (TX) recipients in a prospective nonrandomized U.S. multicenter trial; CONCLUSION: The rates and outcomes of surgical complications are similar to what has been observed in the non-HIV setting in carefully selected HIV-infected liver and kidney TX recipients. Copyright  2012 Mosby, Inc. All rights reserved; METHODS: Subjects were required to have CD4+ T-cell counts >200/100 cells/mm3 (K/L) and undetectable plasma HIV-1 RNA (Viral Load [VL]) (K) or expected posttransplantation suppression (L). Impact of SCs (N >= 7) was evaluated by use of the proportional hazards models. Baseline morbidity predictors for SCs (N >= 7) were assessed in univariate proportional hazards models; RESULTS: At median 2.7 (interquartile range 1.9-4.1) and 2.3 (1.0-3.7) years after TX, 3-month and 1-year graft survival were [K] 96% (95% CI 91%-98%) and 91% (95% CI 85%-94%) and [L] 91% (95% CI 85%-95%) and 77% (95% CI 69%-84%), respectively. A total of 14 K and 28 L graft losses occurred in the first year; 6 K and 11 L were in the first 3 months. A total of 26 (17%) K and 43 (34%) L experienced 29 and 62 SCs, respectively. In the liver multivariate model, re-exploration was marginally associated (hazard ratio [HR] 2.8; 95% CI 1.0-8.4; P = .06) with increased risk of graft loss, whereas a greater MELD score before transplantation (HR 1.07 per point increase; 95% CI: 1.01-1.14; P = .02), and detectable viral load before TX (HR 3.6; 95% CI 0.9-14.6; P = .07) was associated with an increased risk of wound infections/dehiscence
UR  - http://dx.doi.org/10.1016/j.surg.2012.06.012
ER  -