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Year : 2017  |  Volume : 11  |  Issue : 3  |  Page : 160-162

A challenging male patient with retroviral infection on highly active antiretroviral therapy issues with re-transplantation

Department of Nephrology, Madras Medical Mission Hospital, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Georgi Abraham
Madras Medical Mission Hospital, 4A, Dr. Jayalalithaa Nagar, Mogappair, Chennai - 600 037, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijot.ijot_47_17

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A 44-year-old African male with chronic kidney disease Stage V due to hypertension underwent a live related renal transplant in 2005. He was on triple immunosuppression postoperatively. Subsequently, he developed metastatic Kaposi sarcoma requiring reduction in immunosuppression and switching over to rapamycin. He was found to be retrovirus positive on a follow-up visit. His graft function progressively deteriorated requiring dialysis while continuing on highly active antiretroviral therapy. He had multiple infective episodes including acute bacterial endocarditis. He received a second renal transplant from a live-related donor in 2017. Despite repeated dosage adjustments, tacrolimus levels were persistently elevated due to drug-drug interaction with diltiazem and anti-retroviral drugs, despite good allograft function.

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