HOPE in action: A prospective multicenter pilot study of liver transplantation from donors with HIV to recipients with HIV

the HOPE in Action Investigators

doi:10.1111/ajt.16886

HOPE in action: A prospective multicenter pilot study of liver transplantation from donors with HIV to recipients with HIV

the HOPE in Action Investigators

Research output: Contribution to journal › Article › peer-review

42 Scopus citations

Abstract

Liver transplantation (LT) from donors-with-HIV to recipients-with-HIV (HIV D+/R+) is permitted under the HOPE Act. There are only three international single-case reports of HIV D+/R+ LT, each with limited follow-up. We performed a prospective multicenter pilot study comparing HIV D+/R+ to donors-without-HIV to recipients-with-HIV (HIV D−/R+) LT. We quantified patient survival, graft survival, rejection, serious adverse events (SAEs), human immunodeficiency virus (HIV) breakthrough, infections, and malignancies, using Cox and negative binomial regression with inverse probability of treatment weighting. Between March 2016–July 2019, there were 45 LTs (8 simultaneous liver-kidney) at 9 centers: 24 HIV D+/R+, 21 HIV D−/R+ (10 D− were false-positive). The median follow-up time was 23 months. Median recipient CD4 was 287 cells/µL with 100% on antiretroviral therapy; 56% were hepatitis C virus (HCV)-seropositive, 13% HCV-viremic. Weighted 1-year survival was 83.3% versus 100.0% in D+ versus D− groups (p =.04). There were no differences in one-year graft survival (96.0% vs. 100.0%), rejection (10.8% vs. 18.2%), HIV breakthrough (8% vs. 10%), or SAEs (all p >.05). HIV D+/R+ had more opportunistic infections, infectious hospitalizations, and cancer. In this multicenter pilot study of HIV D+/R+ LT, patient and graft survival were better than historical cohorts, however, a potential increase in infections and cancer merits further investigation.

Original language	English (US)
Pages (from-to)	853-864
Number of pages	12
Journal	American Journal of Transplantation
Volume	22
Issue number	3
DOIs	https://doi.org/10.1111/ajt.16886
State	Published - Mar 2022

Funding

This work was supported by the by National Institute of Allergy and Infectious Diseases grant numbers 1P30AI094189 (Johns Hopkins Center for AIDS Research), 1R01AI120938 (Tobian), U01AI138897 (Durand/Segev), and U01AI134591 (Durand/Segev) and in part by the Division of Intramural Research, NIAID, NIH (Quinn and Redd), and the Regional Oncology Research Center, 3P30CA006973 NCI/NIH (Nelson) and with federal funds from the National Cancer Institute, National Institutes of Health under Contract No. HHSN261200800001E and Contract No. 75N91019D00024 (Whitby). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the U.S. Government. This work was supported by the by National Institute of Allergy and Infectious Diseases grant numbers 1P30AI094189 (Johns Hopkins Center for AIDS Research), 1R01AI120938 (Tobian), U01AI138897 (Durand/Segev), and U01AI134591 (Durand/Segev) and in part by the Division of Intramural Research, NIAID, NIH (Quinn and Redd), and the Regional Oncology Research Center, 3P30CA006973 NCI/NIH (Nelson) and with federal funds from the National Cancer Institute, National Institutes of Health under Contract No. HHSN261200800001E and Contract No. 75N91019D00024 (Whitby). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the U.S. Government. Columbia University Medical Center: Marcus Pereira MD MPH, Dominique Piquant. Drexel University: Carolyn Edwards RN MSN, Karthik M Ranganna. Duke University: Katherine Link RN. Emory University Transplant Center: Thomas Pearson MD, Aneesh KMehta MD, G. Marshall Lyon MD, William Kitchens MD PhD, Jeryl Huckaby MSCRA CCRC, Rivka Elbein RN BSN, April Roberson RN, Elizabeth Ferry RN. Indiana University: Margaret Adebiyi, Oluwafisayo Adebiyi MD, Chandrahekhar Kubal MD PhD. Johns Hopkins University School of Medicine/Johns Hopkins Hospital: Richard Ambinder, MD PhD, Brittany Barnaba MSN FRN, Gilad Bismut BA, Juli Bollinger MS, Brian Boyarsky MD, Curtisha Charles BS, Willa VCochran CRNP, Niraj NDesai MD, Brianna Doby BA, Jaylyn Johnstone MPH, Charles Kirby BS, Ethan Klock BS, Oyinkansola Kusemiju MPH, Jernelle Miller BA, Michelle Morrison BSN, Michelle Prizzi BA, Haley Schmidt BA, Sarah Rasmussen BA, Jeremy Sugarman MD, Shanti Seaman BA. Massachusetts General Hospital: Margret Thomas BS. MedStar Georgetown Transplant Institute: Aleya Akhran RN, Margaret Coakley RN, Matthew Cooper MD, Alexander Gilbert MD, Alyssa Stucke BS, Joseph Timpone MD. Methodist Health System Clinical Research Institute: Jose ACastillo-Lugo MD, Melba Townsend. The Mount Sinai Hospital, Recanati-Miller Transplantation Institute: Brandy M. Haydel CCRC. Northwestern University: Leah Goudy RN BSN and Lorenzo Gallon MD. NYU Langone Transplant Institute: Rebecca Dieter PharmD, Cecilia Deterville MS CCRC, Elizabeth Klein, Henry Neumann MD, Elaina PWeldon MSN ACNP-BC. Ochsner Clinic Foundation: Jonathan Hand MD, Angela RSmith MBA. Perelman School of Medicine at the University of Pennsylvania: Emily ABlumberg MD, Eileen Donaghy CRNP, Ty Dunn MD, Deirdre Sawinski MD. Rush University: Mark Mall RN, Carlos A. QSantos MDMPHS. University of Alabama at Birmingham: Katherine Basinger RN CCRP, Jayme ELocke MD MPH FACS FAST, Shikha Mehta MD, Darnell Mompoint-Williams CRNP DNP. University of California Los Angeles: Janette Gadzhyan, Joanna Schaenman MD PhD. University of California San Diego: Saima Aslam MD MS, Kristin Mekeel MD, Phirum Nguyen BS. University of California San Francisco: Ada Chao, Joanne Kwan, Rodney Rogers, Tab Srisengf. University of Cincinnati: Senu Apewokin MD FACP, Kathleen Harrison, Samantha Kramer, Rachel Wilkinson. University of Colorado, Denver: Esther Benamu MD. University of Illinois at Chicago: Mario Spaggiari MD, Kelly Bruno. Institute of Human Virology at the University of Maryland School of Medicine: Gregory Brogden, Jennifer Husson MD, Alicia Jeffery MA, Ilise DMarrazzo RN BSN MPH. University of Miami, Miami Transplant Institute: Michele IMorris MD, Carlos Munoz CRC, Jacques Simkins, MD. University of Minnesota: Mary Farnsworth CCRC. University of Pittsburgh: Ghady Haidar MD, Kailey Hughes Kramer MPH, Diana Lynn Pakstis RN BSN MBA, Fernanda Silveira MD MS. University of Texas Southwestern Medical Center: Whitney Baah, Emily Carlson, Ricardo M La Hoz MD. From University of Virginia: Avinash Agarwal MD, Alden Doyle, Jamie Nagy. Virginia Commonwealth University: Mary Baldecchi, Nathaniel Brigle CCRP, Gaurav Gupta MD. Weill Cornell Medicine: Catherine Butkus-Small MD, Thangamani Muthukumar MD. Yale School of Medicine: Maricar Malinis MD, Ricarda Tomlin BS CCRP.

Keywords

clinical research/practice
ethics and public policy
infection and infectious agents - viral: hepatitis C
infection and infectious agents - viral: human herpesvirus 8 (HHV-8)
infection and infectious agents - viral: human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)
infectious disease
liver disease
liver disease: infectious
liver transplantation/hepatology

ASJC Scopus subject areas

Immunology and Allergy
Transplantation
Pharmacology (medical)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1111/ajt.16886

Cite this

@article{f172a5599143471bbf31017e87fd8eb2,

title = "HOPE in action: A prospective multicenter pilot study of liver transplantation from donors with HIV to recipients with HIV",

abstract = "Liver transplantation (LT) from donors-with-HIV to recipients-with-HIV (HIV D+/R+) is permitted under the HOPE Act. There are only three international single-case reports of HIV D+/R+ LT, each with limited follow-up. We performed a prospective multicenter pilot study comparing HIV D+/R+ to donors-without-HIV to recipients-with-HIV (HIV D−/R+) LT. We quantified patient survival, graft survival, rejection, serious adverse events (SAEs), human immunodeficiency virus (HIV) breakthrough, infections, and malignancies, using Cox and negative binomial regression with inverse probability of treatment weighting. Between March 2016–July 2019, there were 45 LTs (8 simultaneous liver-kidney) at 9 centers: 24 HIV D+/R+, 21 HIV D−/R+ (10 D− were false-positive). The median follow-up time was 23 months. Median recipient CD4 was 287 cells/µL with 100% on antiretroviral therapy; 56% were hepatitis C virus (HCV)-seropositive, 13% HCV-viremic. Weighted 1-year survival was 83.3% versus 100.0% in D+ versus D− groups (p =.04). There were no differences in one-year graft survival (96.0% vs. 100.0%), rejection (10.8% vs. 18.2%), HIV breakthrough (8% vs. 10%), or SAEs (all p >.05). HIV D+/R+ had more opportunistic infections, infectious hospitalizations, and cancer. In this multicenter pilot study of HIV D+/R+ LT, patient and graft survival were better than historical cohorts, however, a potential increase in infections and cancer merits further investigation.",

keywords = "clinical research/practice, ethics and public policy, infection and infectious agents - viral: hepatitis C, infection and infectious agents - viral: human herpesvirus 8 (HHV-8), infection and infectious agents - viral: human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), infectious disease, liver disease, liver disease: infectious, liver transplantation/hepatology",

author = "{the HOPE in Action Investigators} and Durand, {Christine M.} and Sander Florman and Motter, {Jennifer D.} and Diane Brown and Darin Ostrander and Sile Yu and Tao Liang and Werbel, {William A.} and Andrew Cameron and Shane Ottmann and Hamilton, {James P.} and Redd, {Andrew D.} and Bowring, {Mary G.} and Yolanda Eby and Fernandez, {Reinaldo E.} and Brianna Doby and Nazzarena Labo and Denise Whitby and Wendell Miley and Rachel Friedman-Moraco and Nicole Turgeon and Price, {Jennifer C.} and Peter Chin-Hong and Peter Stock and Valentina Stosor and Varvara A Kirchner and Timothy Pruett and David Wojciechowski and Nahel Elias and Cameron Wolfe and Quinn, {Thomas C.} and Jonah Odim and Megan Morsheimer and Mehta, {Sapna A.} and Rana, {Meenakshi M.} and Shirish Huprikar and Allan Massie and Tobian, {Aaron A.R.} and Segev, {Dorry L.} and Marcus Pereira and Dominique Piquant and Carolyn Edwards and Ranganna, {Karthik M.} and Katherine Link and Thomas Pearson and Mehta, {Aneesh K.} and Lyon, {G. Marshall} and William Kitchens and Jeryl Huckaby and Lorenzo Gallon",

note = "Publisher Copyright: {\textcopyright} 2021 The American Society of Transplantation and the American Society of Transplant Surgeons",

year = "2022",

month = mar,

doi = "10.1111/ajt.16886",

language = "English (US)",

volume = "22",

pages = "853--864",

journal = "American Journal of Transplantation",

issn = "1600-6135",

publisher = "Elsevier B.V.",

number = "3",

}

TY - JOUR

T1 - HOPE in action

T2 - A prospective multicenter pilot study of liver transplantation from donors with HIV to recipients with HIV

AU - the HOPE in Action Investigators

AU - Durand, Christine M.

AU - Florman, Sander

AU - Motter, Jennifer D.

AU - Brown, Diane

AU - Ostrander, Darin

AU - Yu, Sile

AU - Liang, Tao

AU - Werbel, William A.

AU - Cameron, Andrew

AU - Ottmann, Shane

AU - Hamilton, James P.

AU - Redd, Andrew D.

AU - Bowring, Mary G.

AU - Eby, Yolanda

AU - Fernandez, Reinaldo E.

AU - Doby, Brianna

AU - Labo, Nazzarena

AU - Whitby, Denise

AU - Miley, Wendell

AU - Friedman-Moraco, Rachel

AU - Turgeon, Nicole

AU - Price, Jennifer C.

AU - Chin-Hong, Peter

AU - Stock, Peter

AU - Stosor, Valentina

AU - Kirchner, Varvara A

AU - Pruett, Timothy

AU - Wojciechowski, David

AU - Elias, Nahel

AU - Wolfe, Cameron

AU - Quinn, Thomas C.

AU - Odim, Jonah

AU - Morsheimer, Megan

AU - Mehta, Sapna A.

AU - Rana, Meenakshi M.

AU - Huprikar, Shirish

AU - Massie, Allan

AU - Tobian, Aaron A.R.

AU - Segev, Dorry L.

AU - Pereira, Marcus

AU - Piquant, Dominique

AU - Edwards, Carolyn

AU - Ranganna, Karthik M.

AU - Link, Katherine

AU - Pearson, Thomas

AU - Mehta, Aneesh K.

AU - Lyon, G. Marshall

AU - Kitchens, William

AU - Huckaby, Jeryl

AU - Gallon, Lorenzo

PY - 2022/3

Y1 - 2022/3

N2 - Liver transplantation (LT) from donors-with-HIV to recipients-with-HIV (HIV D+/R+) is permitted under the HOPE Act. There are only three international single-case reports of HIV D+/R+ LT, each with limited follow-up. We performed a prospective multicenter pilot study comparing HIV D+/R+ to donors-without-HIV to recipients-with-HIV (HIV D−/R+) LT. We quantified patient survival, graft survival, rejection, serious adverse events (SAEs), human immunodeficiency virus (HIV) breakthrough, infections, and malignancies, using Cox and negative binomial regression with inverse probability of treatment weighting. Between March 2016–July 2019, there were 45 LTs (8 simultaneous liver-kidney) at 9 centers: 24 HIV D+/R+, 21 HIV D−/R+ (10 D− were false-positive). The median follow-up time was 23 months. Median recipient CD4 was 287 cells/µL with 100% on antiretroviral therapy; 56% were hepatitis C virus (HCV)-seropositive, 13% HCV-viremic. Weighted 1-year survival was 83.3% versus 100.0% in D+ versus D− groups (p =.04). There were no differences in one-year graft survival (96.0% vs. 100.0%), rejection (10.8% vs. 18.2%), HIV breakthrough (8% vs. 10%), or SAEs (all p >.05). HIV D+/R+ had more opportunistic infections, infectious hospitalizations, and cancer. In this multicenter pilot study of HIV D+/R+ LT, patient and graft survival were better than historical cohorts, however, a potential increase in infections and cancer merits further investigation.

AB - Liver transplantation (LT) from donors-with-HIV to recipients-with-HIV (HIV D+/R+) is permitted under the HOPE Act. There are only three international single-case reports of HIV D+/R+ LT, each with limited follow-up. We performed a prospective multicenter pilot study comparing HIV D+/R+ to donors-without-HIV to recipients-with-HIV (HIV D−/R+) LT. We quantified patient survival, graft survival, rejection, serious adverse events (SAEs), human immunodeficiency virus (HIV) breakthrough, infections, and malignancies, using Cox and negative binomial regression with inverse probability of treatment weighting. Between March 2016–July 2019, there were 45 LTs (8 simultaneous liver-kidney) at 9 centers: 24 HIV D+/R+, 21 HIV D−/R+ (10 D− were false-positive). The median follow-up time was 23 months. Median recipient CD4 was 287 cells/µL with 100% on antiretroviral therapy; 56% were hepatitis C virus (HCV)-seropositive, 13% HCV-viremic. Weighted 1-year survival was 83.3% versus 100.0% in D+ versus D− groups (p =.04). There were no differences in one-year graft survival (96.0% vs. 100.0%), rejection (10.8% vs. 18.2%), HIV breakthrough (8% vs. 10%), or SAEs (all p >.05). HIV D+/R+ had more opportunistic infections, infectious hospitalizations, and cancer. In this multicenter pilot study of HIV D+/R+ LT, patient and graft survival were better than historical cohorts, however, a potential increase in infections and cancer merits further investigation.

KW - clinical research/practice

KW - ethics and public policy

KW - infection and infectious agents - viral: hepatitis C

KW - infection and infectious agents - viral: human herpesvirus 8 (HHV-8)

KW - infection and infectious agents - viral: human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)

KW - infectious disease

KW - liver disease

KW - liver disease: infectious

KW - liver transplantation/hepatology

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UR - http://www.scopus.com/inward/citedby.url?scp=85120604398&partnerID=8YFLogxK

U2 - 10.1111/ajt.16886

DO - 10.1111/ajt.16886

M3 - Article

C2 - 34741800

AN - SCOPUS:85120604398

SN - 1600-6135

VL - 22

SP - 853

EP - 864

JO - American Journal of Transplantation

JF - American Journal of Transplantation

IS - 3

ER -

HOPE in action: A prospective multicenter pilot study of liver transplantation from donors with HIV to recipients with HIV

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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