Affiliation:
1. Department of Cardiothoracic Surgery University of Pittsburgh Pittsburgh Pennsylvania USA
2. Division of Infectious Diseases University of Pittsburgh Pittsburgh Pennsylvania USA
3. Division of Thoracic Surgery and Lung Transplantation Thoracic Center IRCCS ISMETT ‐ UPMC Palermo Italy
4. Pulmonary, Allergy, Critical Care, and Sleep Medicine University of Pittsburgh Pittsburgh Pennsylvania USA
Abstract
AbstractBackgroundExperience with lung transplantation (LT) in patients with human immunodeficiency virus (HIV) is limited. Many studies have demonstrated the success of kidney and liver transplantation in HIV‐seropositive (HIV+) patients. Our objective was to conduct a national registry analysis comparing LT outcomes in HIV+ to HIV‐seronegative (HIV−) recipients.MethodsThe United Network for Organ Sharing database was queried to identify LTs performed in adult HIV+ patients between 2016 and 2023. Patients with unknown HIV status, multiorgan transplants, and redo transplants were excluded. The primary endpoints were mortality and graft rejection. Survival time was analyzed using Kaplan–Meier analysis.ResultsThe study included 17 487 patients, 67 of whom were HIV+. HIV+ recipients were younger (59 vs. 62 years, p = .02), had higher pulmonary arterial pressure (28 vs. 25 mm Hg, p = .04), and higher lung allocation scores (47 vs. 41, p = .01) relative to HIV− recipients. There were no differences in graft/recipient survival time between groups. HIV+ recipients had higher rates of post‐transplant dialysis (18% vs. 8.4%, p = .01), but otherwise had similar post‐transplant outcomes to HIV‐recipients.ConclusionsThis national registry analysis suggests LT outcomes in HIV+ patients are not inferior to outcomes in HIV− patients and that well‐selected HIV+ recipients can achieve comparable patient and graft survival rates relative to HIV− recipients.