Secondary Logo

Institutional members access full text with Ovid®

Share this article on:

Kaposi Sarcoma in HIV-positive Solid-Organ Transplant Recipients

A French Multicentric National Study and Literature Review

Charpentier, Chloé, MD1; Delyon, Julie, PhD1,2,3; Glotz, Denis, PhD3,4; Peraldi, Marie-Noelle, PhD3,4; Rerolle, Jean-Philippe, MD5; Barrou, Benoît, PhD6; Ducroux, Emilie, MD7; Coilly, Audrey, MD8; Legeai, Camille, MD9; Barete, Stéphane, MD10; Lebbé, Céleste, PhD1,2,3

doi: 10.1097/TP.0000000000002468
Original Clinical Science—General

Background Kaposi sarcoma is a vascular tumor related to herpesvirus-8 and is promoted by immunosuppression. For the last 15 years, human immunodeficiency virus (HIV) patients have had access to organ transplantation. The dual immunosuppression of HIV and immunosuppressive treatments might increase the risk and severity of Kaposi sarcoma.

Methods We conducted a multicentric retrospective study by collecting cases from French databases and society members of transplanted patients, among which 7 HIV-infected patients who subsequently developed Kaposi sarcoma were included.

Results In the CRISTAL database (114 511 patients) and the DIVAT (Données Informatisées et VAlidées en Transplantation) database (19 077 patients), the prevalence of Kaposi sarcoma was 0.18% and 0.46%, respectively, in transplanted patients; these values compare with 0.66% and 0.50%, respectively, in transplanted patients with HIV. The median time from HIV infection to Kaposi sarcoma was 20 years. Kaposi sarcoma occurred during the first year after transplantation in most cases, whereas HIV viral load was undetectable. Only 2 patients had visceral involvement. Five patients were treated with conversion of calcineurin inhibitor to mammalian target of rapamycin inhibitor, and 5 patients were managed by decreasing immunosuppressive therapies. At 1 year, 4 patients had a complete response, and 3 had a partial response.

Conclusions In our study, Kaposi sarcoma in transplanted patients with HIV did not show any aggressive features and was treated with the usual posttransplant Kaposi sarcoma management protocol.

1 APHP Department of Dermatology, Saint Louis Hospital, Paris, France.

2 INSERM U976, France.

3 Paris Diderot University, Sorbonne Paris Cité, France.

4 Department of Nephrology, Saint Louis Hospital, Paris, France.

5 Department of Nephrology, Dupuytren Hospital, Limoges, France.

6 UPMC, Department of Urology, Nephrology and Transplantation, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France.

7 Department of Dermatology, Edouard Herriot Hospital, Lyon, France.

8 Department of Hepatology and Gastrology, Paul Brousse Hospital, Villejuif, France.

9 Biomedicine Agency. Saint-Denis La Plaine, France.

10 UPMC, Unit of Dermatology, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France.

Received 8 June 2018. Revision received 15 September 2018.

Accepted 22 September 2018.

C.C. participated in the writing of the article, participated in the research design, participated in the performance of the research, contributed new reagents or analytic tools, and participated in the data analysis. J.D. participated in the writing of the article, participated in the research design, participated in the performance of the research, contributed new reagents or analytic tools, and participated in the data analysis. D.G. participated in the research design, participated in the performance of the research, and contributed new reagents or analytic tools. M.-N.P. participated in the performance of the research and contributed new reagents or analytic tools. J.-P.R. participated in the performance of the research and contributed new reagents or analytic tools. B.B. participated in the performance of the research and contributed new reagents or analytic tools. E.D. participated in the performance of the research and contributed new reagents or analytic tools. A.C. participated in the performance of the research and contributed new reagents or analytic tools. C.L. participated in the performance of the research and contributed new reagents or analytic tools. S.B. participated in research design, participated in the performance of the research, and contributed new reagents or analytic tools. C.L. participated in the writing of the article, participated in the research design, participated in the performance of the research, contributed new reagents or analytic tools, and participated in the data analysis.

The authors declare no funding or conflicts of interest.

Correspondence: Chloé Charpentier, MD, Department of Dermatology, Saint Louis Hospital, Paris, France. (chloe.charpentier@aphp.fr).

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.