Purpose

The primary objective of this study is to determine if an HIV-infected donor liver (HIVD+) transplant is safe with regards to major transplant-related and HIV-related complications

Condition

Eligibility

Eligible Ages
Over 18 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Participant meets the standard criteria for liver transplant at the local center.
  • Participants being listed for a simultaneous liver kidney (SLK) are eligible if participants meet the standard criteria for both organs.
  • Participant is able to understand and provide informed consent.
  • Participant meets with an independent advocate per the HIV Organ Policy Equity (HOPE) Act Safeguards and Research Criteria.
  • Documented HIV infection (by any licensed assay or documented history of detectable HIV-1 RNA).*
  • Participant is ≥ 18 years old.
  • Opportunistic complications: prior history of certain opportunistic infections is not an exclusion if the participant has received appropriate therapy and has no evidence of active disease. Medical record documentation should be provided whenever possible.
  • CD4+ T-cell count: ≥ 100/µL within 16 weeks prior to transplant if no history of AIDS-defining infection; or ≥ 200 μL if history of opportunistic infection is present.
  • HIV-1 RNA is below 50 RNA/mL.* Viral blips between 50-400 copies will be allowed as long as there are not consecutive measurements > 200 copies/mL. *Organ recipients who are unable to tolerate anti-retroviral therapy (ART) due to organ.

failure or recently started ART may be eligible despite a detectable viral load if safe and effective ART to be used by the recipient after transplantation is described.

- Participant must have or be willing to start seeing a primary medical care provider with expertise in HIV management.

- Participant is willing to comply with all medications related to participant's transplant and HIV management.

- For participants with a history of aspergillus colonization or disease, no current clinical evidence of active disease.

- Agreement to use contraception.

- Participant is not suffering from significant wasting (e.g. body mass index < 21) thought to be related to HIV disease.

Exclusion Criteria

  • Participant has a history of progressive multifocal leukoencephalopathy (PML), or primary central nervous system (CNS) lymphoma.*
  • Participant is pregnant or breastfeeding. (Note: Participants who become pregnant post-transplant will continue to be followed in the study and will be managed per local site practice. Women that become pregnant should not breastfeed.)
  • Past or current medical problems or findings from medical history, physical examination or laboratory testing that are not listed above, which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained from the study.

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
HIV D+/R+
HIV-infected individuals that accept an organ from an HIV-infected deceased donor - enrollment 40
  • Other: HIVD+/R+
    Liver from an HIV-infected deceased donor
No Intervention
HIVD-/R+
HIV-infected individuals that accept an organ from an HIV-uninfected deceased donor and are randomized to participate in the full study arm, which includes research sample collection -enrollment 40
No Intervention
HIVD-/R+ (observational)
HIV-infected individuals that accept an organ from an HIV-uninfected deceased donor and randomized to observational group with limited data collection - enrollment 120

Recruiting Locations

University of Arkansas for Medical Sciences
Little Rock, Arkansas 72205
Contact:
Emmanouil Giorgakis, MD
egiorgakis@uams.edu

University of California, San Diego
San Diego, California 92103
Contact:
Saima Aslam, MD
saslam@ucsd.edu

University of California, San Francisco
San Francisco, California 94193
Contact:
Jennifer Price, MD
jennifer.price@ucsf.edu

Yale University School of Medicine
New Haven, Connecticut 06520-8022
Contact:
Maricar Malinis, MD
203-785-3561
maricar.malinis@yale.edu

University of Miami
Miami, Florida 33136
Contact:
Jacque Simkins-Cohen, MD
jsimkins@med.miami.edu

Emory University
Atlanta, Georgia 30322
Contact:
William H. Kitchens Jr., MD, PhD
404-727-8196
william.henry.kitchens.jr@emory.edu

Northwestern University
Chicago, Illinois 60611
Contact:
Valentina Stosor, MD
312-695-5085
v-stosor@morthwestern.edu

University of Illinois at Chicago
Chicago, Illinois 60612
Contact:
Mario Spaggiari, MD
312-675-9570
mspaggia@uic.edu

Ochsner Clinic Foundation
New Orleans, Louisiana 70121
Contact:
Jonathan Hand, MD
jonathan.hand@ochsner.org

University of Maryland, Institute of Human Virology
Baltimore, Maryland 21201
Contact:
Jennifer Husson, MD, MPH
410-706-8614
jhusson@ihv.umaryland.edu

Johns Hopkins University
Baltimore, Maryland 21205
Contact:
Christine Durand, MD
410-955-5684
cdurand2@jhmi.edu

Massachusetts General Hospital
Boston, Massachusetts 02114
Contact:
Nahel Elias, MD
617-726-0174
elias.nahel@mgh.harvard.edu

Icahn School of Medicine at Mount Sinai
New York, New York 10029
Contact:
Sander Florman, MD
212-659-8313
sander.florman@mountsinai.org

Columbia University Medical Center
New York, New York 10032
Contact:
Marcus Pereira, MD, MPH
212-305-3839
mp2323@cumc.columbia.edu

New York University School of Medicine
New York, New York 11016
Contact:
Sapna Mehta, MD
646-754-1006
sapna.mehta@nyumc.org

University of Cincinnati
Cincinnati, Ohio 45267
Contact:
Senu Apewokin, MD
513-558-4253
apewoksu@ucmail.uc.edu

UPMC - University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania 15213
Contact:
Ghady Haidar, MD
412-648-6212
haidarg@upmc.edu

More Details

NCT ID
NCT03734393
Status
Recruiting
Sponsor
Johns Hopkins University

Study Contact

Christine Durand, MD
410-955-5684
cdurand2@jhmi.edu

Detailed Description

This study will evaluate if receiving a liver transplant from an HIV-infected deceased liver donor is safe with regards to survival and major transplant-related and HIV-related complications compared to receiving a liver from an HIV-uninfected deceased liver donor (HIVD-). Those participants who have accepted an HIVD- organ will be randomized to be followed in the full study or followed in the nested observational group

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.