Renal transplantation in HIV-positive renal transplant recipients: experience at the Mannheim University Hospital

Renal transplantation in HIV-positive patients with end-stage renal disease has in recent years become a successful treatment option. We report two patients who underwent renal transplantation using a combination of basiliximab, calcineurin inhibitors, mycophenolate mofetil (MMF), and steroids with...

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Main Authors: Haas, Jenny (Author) , Singer, Thomas (Author) , Nowak, Kai (Author) , Göttmann, Uwe (Author) , Schnülle, Peter (Author) , Krüger, Bernd (Author) , Krämer, Bernhard (Author) , Benck, Urs Tobias (Author)
Format: Article (Journal)
Language:English
Published: November 2015
In: Transplantation proceedings
Year: 2015, Volume: 47, Issue: 9, Pages: 2791-2794
ISSN:1873-2623
DOI:10.1016/j.transproceed.2015.09.064
Online Access:Verlag, Volltext: http://dx.doi.org/10.1016/j.transproceed.2015.09.064
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0041134515009938
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Author Notes:J. Haas, T. Singer, K. Nowak, J. Brust, U. Göttmann, P. Schnülle, B. Krüger, B.K. Krämer, U. Benck

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520 |a Renal transplantation in HIV-positive patients with end-stage renal disease has in recent years become a successful treatment option. We report two patients who underwent renal transplantation using a combination of basiliximab, calcineurin inhibitors, mycophenolate mofetil (MMF), and steroids with a “non-interacting” antiretroviral combination therapy consisting of stavudine or abacavir, lamivudine, and nevirapine. We observed no acute rejection but a BK polyomavirus infection in both patients. In conclusion, a quadruple immunosuppression with an interleukin 2 receptor antagonist, a calcineurin inhibitor, MMF, and steroids appears to be advisable to prevent high rates of acute rejection, but if possible thereafter immunosuppression should be tapered rapidly (eg, MMF stop, prednisolone dose 5 mg/d). The selection of antiretroviral agents should avoid compounds that interact severely with the immunosuppression used. 
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