University of Heidelberg Heidelberg Germany Email: martin_zeier{at}med.uni-heidelberg.de
Sir,
The authors quote a single centre experience where 12 HIV-positive dialysis patients received a renal allograft [1]. After 1 year all recipients were alive with a functioning allograft.
In our opinion it is too early to draw firm conclusions from this preliminary report, which was submitted as an abstract at the most recent meeting of the American Society of Transplantation. The follow-up of these patients is rather short and in our opinion this report is not sufficient to reconsider the present policy which holds HIV patients back from renal transplantation. In addition, the authors [1] mention several difficulties, one of them being the adjustment of immunosuppressives due to the interaction with the ongoing antiviral therapy and another the development of HIV-associated nephropathy. Long-term follow-up of more patients is necessary before final conclusions can be drawn. At present, the majority of transplant centres would not accept HIV-positive patients for renal transplantation.
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