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• W2158668547 abstract "questions remain. Encouraging preliminary studies have been small and of relatively short duration. In addition, we have observed an unusually high incidence of rejection among our kidney transplant recipients that remains unexplained6,12. Finally, the outcomes of HCV co-infected liver transplant recipients have been mixed, and several cases of rapid and severe recurrent HCV have been reported2,10,24,25. As long as there is uncertainty, some will argue that it is unethical to utilize the deceased donor pool and thus deprive another transplant candidate from the benefit of that organ, or put living donors at risk. The amount of data required to resolve these concerns remains a contentious issue in the United States. We concur with the Spanish Consensus Document that sufficient data exist at this time26,27. In fact, in the absence of data demonstrating poor outcomes, it can be reasonably argued that is no longer ethical to withhold this option from patients with HIV infection. To definitively resolve these ethical and clinical dilemmas, it would be optimal for every willing HIV-infected transplant recipient to contribute by participating in a clinical outcomes study. Thus, it is important that coincident with the publication of this Consensus Document, the Spanish AIDS Foundation has provided funds to prospectively collect data related to all liver transplantation in Spain during 2005-07. We would advocate that additional funds be pursued to include all kidney transplant recipients as well. The challenge now, as undertaken in the Consensus Document, is to develop patient selection and clinical management guidelines while we await definitive data describing predictors of good and poor outcomes. We will review several areas where the Spanish Consensus Document differs from the clinical trial protocol employed in the United States National Institutes of Health (NIH) sponsored 20-center study of liver and kidney transplantation. As noted by the authors of the Spanish Consensus Document, “this field is evolving continuously and the indications for transplant or management of these patients may change as more evidence becomes available. Therefore, this Committee undertakes to provide periodic updates of this document.” We concur that reevaluation of existing data and flexibility are imperative in this rapidly evolving field." @default.
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• W2158668547 date "2005-06-01" @default.
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• W2158668547 title "Comprehensive guidelines translate research findings into clinical policy for HIV-infected transplant candidates and recipients" @default.
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• W2158668547 doi "https://doi.org/10.1157/13076171" @default.
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