Lung Transplantation for People Living With HIV: Promising Mid-term Outcomes

Area of Science:

• Transplantation immunology
• Infectious diseases
• Pulmonology

Background:

• Increasing life expectancy leads to more chronic diseases in people living with HIV (PLWH).
• End-stage lung disease in PLWH may necessitate lung transplant (LTx), previously contraindicated.
• Limited data exist on LTx outcomes for PLWH.

Purpose of the Study:

• To evaluate the outcomes of lung transplant (LTx) in people living with HIV (PLWH).
• To compare survival and postoperative complications between PLWH and HIV-negative lung transplant recipients.

Main Methods:

• Utilized the Organ Procurement and Transplantation Network (OPTN) STAR file to identify LTx recipients with HIV.
• Propensity score matching created a control group of HIV-negative LTx recipients.
• Compared patient characteristics, transplant parameters, survival, and postoperative outcomes.

Main Results:

• Fifty-nine LTx recipients with HIV were compared to 236 HIV-negative controls.
• PLWH had higher rates of positive cytomegalovirus status and received higher Lung Allocation Scores.
• Postoperative dialysis was more common in PLWH, but overall complication rates and survival were similar (1-year: 91.2% vs 88.6%; 3-year: 82.6% vs 77.8%).

Conclusions:

• Lung transplant (LTx) recipients living with HIV demonstrate comparable survival rates to matched HIV-negative controls.
• These findings support LTx as a viable treatment option for PLWH with end-stage lung disease.