Organ Transplantation in HIV-Positive Patients with Hemophilia

Abstract

An important question concerning transplantation is whether the subsequent survival and quality of life justify the procedure in HIV-infected patients. We reviewed or followed the course of five HIV-positive persons with hemophilia who underwent transplantation — four of a liver and one of a heart — between 1982 and 1987^{1 2 3 4} ( Table 1 ). All had asymptomatic HIV infection at the time of operation. Liver transplantation was performed in four patients because of end-stage liver disease due to long-term transfusion therapy, and heart transplantation was performed in one because of end-stage myocardiopathy due to a thrombotic infarction that was complicating therapy with factor IX concentrate. One (Patient 1) died perioperatively of surgical complications and thus could not be evaluated. Of the four patients who could be evaluated, all survived transplantation but unfortunately went on to have AIDS 3, 14, 24, and 41 months later. Three have since died of complications of AIDS.