부산대학교 도서관

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1600-6143.2009.02779.x Byline: A. Bertani (a), P. Grossi (bc), P. Vitulo (d), G. D'Ancona (a), A. Arcadipane (e), A. Nanni Costa (f), B. Gridelli (g) Keywords: lung transplantation; HIV infection; cystic fibrosis; hepatitis B virus (HBV); immunosuppression Abstract: Prior to the advent of highly active antiretroviral therapy (HAART), HIV-infected patients were usually not considered as transplant candidates because of the poor prognosis of their underlying disease and concerns regarding the potential detrimental effects of immunosuppression on viral load and immune status. However, with the significant HAART-associated improvements in morbidity and mortality, good short-term outcomes after liver and kidney transplantation for patients with HIV infection have been reported. Nevertheless, HIV infection is currently considered a contraindication to lung transplantation in most transplant centers worldwide. The results of a double lung transplant performed in an HIV and HBV co-infected patient with cystic fibrosis (CF) and end-stage respiratory failure (ESRF) are presented after a 2-year follow-up. Approval of and recommendations for the management of this patient were obtained from the Italian National Center for Transplantation as an extension of the ongoing Italian protocol for liver and kidney transplantation in HIV-infected individuals. The operation was successful and the patient recovered rapidly after surgery. A cautious infectious and immunosuppressive management allowed so far the avoidance of major infectious complications and rejection. To the best of our knowledge, this is the first report of lung transplantation in an HIV and HBV co-infected patient. Author Affiliation: (a)Department of Cardiothoracic Surgery, Ismett-UPMC Italy, Palermo, Italy (b)Department of Infectious Disease, Ismett-UPMC Italy, Palermo, Italy (c)Department of Infectious Disease, Insubria University, Varese, Italy (d)Department of Pulmonology, Ismett-UPMC Italy, Palermo, Italy (e)Department of Anesthesia and Critical Care Medicine, Ismett-UPMC Italy, Palermo, Italy (f)Centro Nazionale Trapianti, Istituto Superiore di Sanita, Rome, Italy (g)Department of Surgery, Ismett, UPMC Italy, Palermo, Italy Article History: Received 2 January 2009, revised 15 June 2009 and accepted for publication 19 June 2009 Article note: (*) Corresponding author: Alessandro Bertani, abertani@ismett.edu