Update in HIV infection in organ transplantation.

PURPOSE OF REVIEW: With reductions in AIDS-related mortality, patients with HIV infection are dying and experiencing significant morbidity from end-stage organ disease. However, patients infected with HIV have traditionally been excluded from organ transplantation. Recent advances have had a significant impact on the potential transplant candidacy of these patients. This review will highlight the major issues associated with transplantation in individuals who are infected with HIV.

RECENT FINDINGS: Recently published studies showing promising preliminary outcomes among transplant recipients with HIV infection, suggest that it is not any more justifiable to deny transplantation based solely on HIV-infection status. These studies consistently describe stable HIV disease following liver and kidney transplantation. Furthermore, combined pancreas-kidney, heart, and lung transplantation has been successfully reported, although in a much smaller number of patients. Despite these scientific and policy advances, many healthcare providers and patients remain unaware of ongoing progress in this field.

SUMMARY: The experience with organ transplantation in HIV-infected patients is evolving and successful outcomes have been observed when specific criteria are used to select candidates.