Outcomes of ABO-incompatible liver transplantation in end-stage liver disease patients co-infected with hepatitis B and human immunodeficiency virus  

作　　者：Jian-Xin Tang Kang-Jun Zhang Tai-Shi Fang Rui-Hui Weng Zi-Ming Liang Xu Yan Xin Jin Lin-Jie Xie Xin-Chen Zeng Dong Zhao 

机构地区：[1]Department of Liver Surgery and Organ Transplantation Center,The Third People's Hospital of Shenzhen(The Second Affiliated Hospital of Southern University of Science and Technology),Shenzhen 518000,Guangdong Province,China [2]Department of Neurology,The Third People’s Hospital of Shenzhen(The Second Affiliated Hospital of Southern University of Science and Technology),Shenzhen 518000,Guangdong Province,China [3]Department of Liver Surgery and Organ Transplantation Center,National Clinical Research Center for Infectious Disease,Shenzhen 518000,Guangdong Province,China

出　　处：《World Journal of Gastroenterology》2023年第11期1745-1756,共12页世界胃肠病学杂志（英文版）

基　　金：Supported by The Third People's Hospital of Shenzhen Scientific Research Project,No.G2021008 and No.G2022008;Shenzhen Key Medical Discipline Construction Fund,No.SZXK079;Shenzhen Science and Technology Research and Development Fund,No.JCYJ20210324131809027 and No.JCYJ20220530163011026.

摘　　要：BACKGROUND Human immunodeficiency virus(HIV)-positive patients coinfected with hepatitis B virus(HBV)are eligible for liver transplantation(LT)in Africa and Southeast Asia,particularly China.However,the outcome of HIV-HBV coinfected patients referred for ABO-incompatible LT(ABOi-LT)is unknown.AIM To clarify the outcome of ABOi-LT for HIV-HBV coinfected patients with endstage liver disease(ESLD).METHODS We report on two Chinese HIV-HBV coinfected patients with ESLD who underwent A to O brain-dead donor LT and reviewed the literature on HIV-HBV coinfected patients treated with ABO-compatible LT.The pretransplantation HIV viral load was undetectable,with no active opportunistic infections.Induction therapy consisted of two sessions of plasmapheresis and a single dose of rituximab in two split doses,followed by an intraoperative regimen of intravenous immunoglobulin,methylprednisolone,and basiliximab.Post-transplant maintenance immunosuppressive agents consisted of tacrolimus and mycophenolate mofetil,and prednisone.RESULTS At the intermediate-term follow-up,patients showed undetectable HIV viral load,CD4(+)T cell counts greater than 150 cells/μL,no HBV recurrence,and stable liver function.A liver allograft biopsy showed no evidence of acute cellular rejection.Both patients survived at 36-42 mo of follow-up.CONCLUSION This is the first report of ABOi-LT in HIV-HBV recipients with good intermediate-term outcomes,suggesting that ABOi-LT may be feasible and safe for HIV-HBV coinfected patients with ESLD.

关 键 词：ABO incompatibility liver transplantation Human immunodeficiency virus Hepatitis B virus End-stage liver disease IMMUNOSUPPRESSION 

分 类 号：R657.3[医药卫生—外科学]