Özet:
Objectives: The outcomes of liver transplant in
human immunodeficiency virus-infected patients are
improving with advances in antiretroviral treatment.
Data about such cases are rare in Turkey. We present
the first 2 living-donor liver transplants performed in
Turkey in patients with viral hepatitis/human
immunodeficiency virus coinfection.
Case 1: A 47-year-old man infected with human
immunodeficiency virus with chronic hepatitis B and
D and hepatocellular carcinoma within the Milan
criteria had been taking antiretroviral medication
before his liver transplant. An unrelated right lobe
liver transplant was performed uneventfully in
this patient, who was human immunodeficiency
virus RNA-negative and had a CD4 T-cell count of
500/μL. Antiretroviral treatment continued in the
early postoperative period, and a triple immunosuppressive
regimen consisting of cyclosporine,
mycophenolate mofetil, and steroids was initiated.
Burkholderia cepacia pneumonia developed post -
operatively, and was treated successfully. The patient
was discharged on postoperative day 18, and is still
alive 58 months after the operation.
Case 2: A 62-year-old man with human immunodeficiency
virus and chronic hepatitis C virus
infection was taking antiretroviral treatment before
the liver transplant. The patient was hepatitis C virus
RNA-positive, human immunodeficiency virus RNAnegative,
and had a CD4 T-cell count of 620/μL. His
son was the donor, and a right lobe liver transplant
was performed uneventfully in antiretroviral
treatment continued in the early postoperative
period and a triple immunosuppressive regimen
consisting tacrolimus, mycophenolate mofetil, and
steroids was initiated. Broad-spectrum β-lactamasepositive
Escherichia coli bacteremia and hospitalacquired
pneumonia developed postoperatively
and were treated successfully. The patient was
discharged on postoperative day 19, and remains
alive 13 months after the operation.
Conclusions: Living-donor liver transplant is a
promising treatment choice for end-stage liver
disease in human immunodeficiency virus-infected
patients.
Key words: Human immunodeficiency virus, Liver
transplant, Hepatitis B virus, Hepatitis C virus,
Coinfection
