Heart Transplantation

HIV disease is recognized as an important cause of dilated cardiomyopathy with a reported prevalence of 3.6% among patients with cardiomyopathy, a proportion that is increasing as patients with HIV infection live longer.

Table 2 Cardiac transplantations

without opportunistic infection and without a history of Kaposi’s sarcoma. Two cardiac transplantations with a simple postopera­tive course and no specific complications during follow-up have been performed at La Pitie during the last 2 years. A multidisci­plinary team is required for this therapeutic technique because numerous complex and unpredictable pharmacological and immunological adverse events can occur (Fig. 5) [33].

There is no report of a cardiac assist device

Fig. 5 Heart prepared for transplantation

in HIV-infected patients, but it is only a matter of time before these devices are used in HIV patients. When the patient is on the waiting list for cardiac transplantation, he or she is eligible for a mechanical bridge. Nevertheless, this therapy will be a chal­lenge because the major complication of ventricular assist devices is sepsis. If the number of HIV-infected patients on waiting lists for cardiac transplantation increases in a high proportion, we should ask the contro­versial question concerning the harvesting of a heart in HIV-infected donors.