LAUSR

BACKGROUND We evaluated trends and outcomes of liver transplantation (LT) recipients with/without human immunodeficiency virus (HIV) infection. METHODS LT recipients between 2008-2015 from the United Network for Organ Sharing and Organ Procurement and Transplantation Network (UNOS/OPTN) and European Liver Transplant Registry (ELTR) were included. Trends and characteristics related to survival among LT recipients with HIV infection were determined. RESULTS Among 73 206 LT patients, 658 (0.9%) were HIV-infected. The proportion of LT HIV-infected did not change over time (P-trend=0.16). Hepatitis C virus (HCV) as indication for LT decreased significantly for HIV-infected and uninfected patients (P-trends=0.008 and <0.001). Three-year cumulative graft survival in LT recipients with and without HIV infection was 64.4% and 77.3% (P<0.001), with improvements over time for both, but with HIV-infected patients having greater improvements (P-trends=0.02 and 0.03). Adjusted risk of graft loss was 41% higher in HIV-infected vs. uninfected (aHR,1.41; P<0.001). Among HIV-infected, MELD (aHR,1.04; P<0.001), body mass index <21 kg/m (aHR,1.61; P=0.006), and HCV (aHR,1.83; P<0.001) were associated with graft loss, while more recent period of LT 2012-2015 (aHR, 0.58; P=0.001) and donor with anoxic cause of death (aHR, 0.51; P=0.007) were associated with lower risk of graft loss. CONCLUSIONS Patients with HIV infection account for only 1% of LTs in U.S. and Europe, with fewer LT for HCV disease over time. A static rate of LT among HIV-infected patients may reflect improvements in cirrhosis management and/or persistent barriers to LT. Graft and patient survival among HIV-positive LT recipients have shown improvement over time.