Liver Transplantation in HIV‑Infected Individuals

Several recent reports have shown that end‑stage liver disease is the leading cause of death among HIV‑infected persons in the highly active antiretroviral therapy (HAART) era. Until a few years ago, HIV infection was an exclusion criteria for organ transplantation. One major concern was that administering iatrogenic immunosuppression to an already immunocompromised individual would lead to an increased risk of opportunistic infections and acceleration of HIV‑related disease. However, more recently, because of the significant increase in life expectancy of HIV‑infected persons treated with HAART, liver, kidney, kidney‑pancreas, heart and lung transplantation have been introduced in this patients population in several centers around the world. Despite the limited number of transplanted patients worldwide and the shortness of the follow‑up of a great number of them, ongoing studies confirm that the short term results are comparable with those observed in non HIV‑infected liver transplant (OLT) recipients. It would seem that at this point, there is no medical justification to withhold organs from patients whose HIV infection is well controlled, as their cumulative survival does not dramatically differ from the non‑HIV population. The challenges involved with the care of these patients require a joint effort by a multidisciplinary team.