HIV-positive patient receiving living related renal transplantation: a report of one case and literature review

Objective To summarize the outcomes and clinical experiences of renal transplantation in human immunodeficiency virus (HIV)-positive patients. Methods The clinical data were retrospectively analyzed for one HIV-positive case of renal transplantation. Diagnosed as chronic renal insufficiency 1 year ago, he received hemodialysis. After a positive screen for HIV, he received highly active antiretroviral therapy (HAART) and HIV RNA turned negative 3 months later. CD4+ T cell count was 331 cell/μl at pre-operation and there was no HIV-rated opportunistic infection or cancer. Her mother donated her kidney. Basiliximab and steroid pulse therapy were used preoperatively and immunosuppressants were used after transplantation, including tacrolimus, corticosteroids and mycophenolate mofetil. Results The kidney was transplanted successfully and serum creatinine declined to a normal level at day 4 after transplantation. Because of an interaction between efaverenz and tacrolimus, the blood concentration of tacrolimus was extremely low and the dose of tacrolimus had to be raised to 0.2 mg/(kg·d). Antiroviral therapy remained unchanged. No rejection and other complications were observed. And HIV RNA remained negative. Conclusions Renal transplantation is optimal for HIV-positive patients whose HIV status is completely under control. However, drug interactions needs to be considered during perioperative and postoperative periods. Key words: Human immunodeficiency virus; Uremia; Kidney transplantation; Living donor