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Living donor liver transplant from an HIV-positive mother to her HIV-negative child: opening up new therapeutic options
OBJECTIVE: Transplant a liver from an HIV-positive mother to her HIV-negative child to save the child's life. DESIGN: A unique case of living donor liver transplantation from an HIV-positive mother to her HIV-negative child in South Africa. Two aspects of this case are ground-breaking. First, i...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200383/ https://www.ncbi.nlm.nih.gov/pubmed/30281558 http://dx.doi.org/10.1097/QAD.0000000000002000 |
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author | Botha, Jean Conradie, Francesca Etheredge, Harriet Fabian, June Duncan, Mary Haeri Mazanderani, Ahmad Paximadis, Maria Maher, Heather Britz, Russell Loveland, Jerome Ströbele, Bernd Rambarran, Sharan Mahomed, Adam Terblanche, Alta Beretta, Marisa Brannigan, Liam Pienaar, Michael Archibald-Durham, Lindsay Lang, Allison Tiemessen, Caroline T. |
author_facet | Botha, Jean Conradie, Francesca Etheredge, Harriet Fabian, June Duncan, Mary Haeri Mazanderani, Ahmad Paximadis, Maria Maher, Heather Britz, Russell Loveland, Jerome Ströbele, Bernd Rambarran, Sharan Mahomed, Adam Terblanche, Alta Beretta, Marisa Brannigan, Liam Pienaar, Michael Archibald-Durham, Lindsay Lang, Allison Tiemessen, Caroline T. |
author_sort | Botha, Jean |
collection | PubMed |
description | OBJECTIVE: Transplant a liver from an HIV-positive mother to her HIV-negative child to save the child's life. DESIGN: A unique case of living donor liver transplantation from an HIV-positive mother to her HIV-negative child in South Africa. Two aspects of this case are ground-breaking. First, it involves living donation by someone who is HIV-positive and second it involves controlled transplant of an organ from an HIV-positive donor into an HIV-negative recipient, with the potential to prevent infection in the recipient. METHODS: Standard surgical procedure for living donor liver transplantation at our centre was followed. HIV-prophylaxis was administered preoperatively. Extensive, ultrasensitive HIV testing, over and above standard diagnostic assays, was undertaken to investigate recipient serostatus and is ongoing. RESULTS: Both mother and child are well, over 1 year posttransplantation. HIV seroconversion in our recipient was detected with serological testing at day 43 posttransplant. However, a decline in HIV antibody titres approaching undetectable levels is now being observed. No plasma, or cell-associated HIV-1 DNA has been detected in the recipient at any time-point since transplant. CONCLUSION: This case potentially opens up a new living liver donor pool which might have clinical relevance in countries where there is a high burden of HIV and a limited number of deceased donor organs or limited access to transplantation. However, our recipient's HIV status is equivocal at present and additional investigation regarding seroconversion events in this unique profile is ongoing. |
format | Online Article Text |
id | pubmed-6200383 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-62003832018-11-21 Living donor liver transplant from an HIV-positive mother to her HIV-negative child: opening up new therapeutic options Botha, Jean Conradie, Francesca Etheredge, Harriet Fabian, June Duncan, Mary Haeri Mazanderani, Ahmad Paximadis, Maria Maher, Heather Britz, Russell Loveland, Jerome Ströbele, Bernd Rambarran, Sharan Mahomed, Adam Terblanche, Alta Beretta, Marisa Brannigan, Liam Pienaar, Michael Archibald-Durham, Lindsay Lang, Allison Tiemessen, Caroline T. AIDS Fast Track OBJECTIVE: Transplant a liver from an HIV-positive mother to her HIV-negative child to save the child's life. DESIGN: A unique case of living donor liver transplantation from an HIV-positive mother to her HIV-negative child in South Africa. Two aspects of this case are ground-breaking. First, it involves living donation by someone who is HIV-positive and second it involves controlled transplant of an organ from an HIV-positive donor into an HIV-negative recipient, with the potential to prevent infection in the recipient. METHODS: Standard surgical procedure for living donor liver transplantation at our centre was followed. HIV-prophylaxis was administered preoperatively. Extensive, ultrasensitive HIV testing, over and above standard diagnostic assays, was undertaken to investigate recipient serostatus and is ongoing. RESULTS: Both mother and child are well, over 1 year posttransplantation. HIV seroconversion in our recipient was detected with serological testing at day 43 posttransplant. However, a decline in HIV antibody titres approaching undetectable levels is now being observed. No plasma, or cell-associated HIV-1 DNA has been detected in the recipient at any time-point since transplant. CONCLUSION: This case potentially opens up a new living liver donor pool which might have clinical relevance in countries where there is a high burden of HIV and a limited number of deceased donor organs or limited access to transplantation. However, our recipient's HIV status is equivocal at present and additional investigation regarding seroconversion events in this unique profile is ongoing. Lippincott Williams & Wilkins 2018-10-23 2018-10-10 /pmc/articles/PMC6200383/ /pubmed/30281558 http://dx.doi.org/10.1097/QAD.0000000000002000 Text en Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 |
spellingShingle | Fast Track Botha, Jean Conradie, Francesca Etheredge, Harriet Fabian, June Duncan, Mary Haeri Mazanderani, Ahmad Paximadis, Maria Maher, Heather Britz, Russell Loveland, Jerome Ströbele, Bernd Rambarran, Sharan Mahomed, Adam Terblanche, Alta Beretta, Marisa Brannigan, Liam Pienaar, Michael Archibald-Durham, Lindsay Lang, Allison Tiemessen, Caroline T. Living donor liver transplant from an HIV-positive mother to her HIV-negative child: opening up new therapeutic options |
title | Living donor liver transplant from an HIV-positive mother to her HIV-negative child: opening up new therapeutic options |
title_full | Living donor liver transplant from an HIV-positive mother to her HIV-negative child: opening up new therapeutic options |
title_fullStr | Living donor liver transplant from an HIV-positive mother to her HIV-negative child: opening up new therapeutic options |
title_full_unstemmed | Living donor liver transplant from an HIV-positive mother to her HIV-negative child: opening up new therapeutic options |
title_short | Living donor liver transplant from an HIV-positive mother to her HIV-negative child: opening up new therapeutic options |
title_sort | living donor liver transplant from an hiv-positive mother to her hiv-negative child: opening up new therapeutic options |
topic | Fast Track |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200383/ https://www.ncbi.nlm.nih.gov/pubmed/30281558 http://dx.doi.org/10.1097/QAD.0000000000002000 |
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