Lung Transplant in HIV-Infected Patients. Single Centre Experience

Purpose The aim of the study was to review the experience of lung transplantation (LT) in HIV-seropositive patients in a referral center. Methods Prospectively, from the first VIH patient accepted for LT in our center we followed all the cases of HIV-infected patients submitted to LT from October 2018 to July 2019. Demographics, CD4 counts and VIH viral loads before and after LT, postoperative and specific VIH complications like opportunistic infections, drug interactions and drug adjustments were recorded. Results In the study period seven VIH patients have been submitted for LT. Only one patient was rejected due to unacceptable surgical risk. The other six patients were accepted; one of them is still on the waiting list, and five patients have been transplanted. Demographics and VIH related characteristics are shown in Table 1. Combined antiretroviral therapy had to be change in two cases: one changed from dultegravir, rilpivirine to emtricitabina, tenofovir and dolutegravir to avoid interactions with pantoprazole; the other one changed from neviparina, raltegravir to emtricitabina, tenofovir, alafenamida and raltegravir to manage renal disfunction. Post-LT results are presented in Table 2. Mean follow up time is 14 (SD 4) months. Only one patient has passed away due to Stenotrophomonas maltophilia graft pneumonia. At the end of the study the other four patients have been discharged and are improving the pulmonary function tests (Table 2). Conclusion The experience of the first five VIH LT patients in Spain shows that LT is feasible without increasing the risk of infectious or immunological complications.