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Perioperative considerations in HIV-infected liver transplanted patients.

Abstract：

UNLABELLED:The introduction of highly active antiretroviral therapy (HAART) has improved survival in HIV patients, allowing them to undergo liver transplantation (OLT) in cases of end-stage liver disease. HIV patients show a higher incidence of pulmonary hypertension. The aim of this study was to evaluate pulmonary and systemic hemodynamic changes in HIV-infected patients compared with a non-HIV-infected group of patients undergoing OLT. METHODS:We analyzed 20 HIV-infected patients and 20 non-HIV-infected patients who underwent OLT. We analyzed preoperative cardiovascular status, as well as intra- and postoperative hemodynamic data. Hemodynamic data were recorded at 4 predefined phases during OLT and at 24, 48, and 72 hours after intensive care unit (ICU) admission. We also evaluated the following perioperative aspects: transfusion requirements, postoperative mechanical ventilation time, ventilation time, and length of ICU and of hospital stay. RESULTS:HIV-positive patients were younger than controls with a greater incidence of coinfection with hepatotropic viruses. One HIV-infected patient died in the ICU. Hemodynamic data showed a higher cardiac index and higher pulmonary vascular resistance index among HIV-infected patients, but without any clinical impact. No significant difference in blood unit transfusions, postoperative time on mechanical ventilation, or length of ICU or hospital stay was observed between the groups. CONCLUSIONS:Although the number of patients studied is limited, we concluded that HIV-infected patients undergoing OLT showed similar perioperative courses as non-HIV-infected patients.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Costa MG,Pompei L,Chiarandini P,Lugano M,Baccarani U,Tavio M,Della Rocca G

doi

10.1016/j.transproceed.2009.03.002

subject

Has Abstract

pub_date

2009-05-01 00:00:00

pages

1249-52

issue

4

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(09)00388-1

journal_volume

41

pub_type

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