With the widespread adoption of antiretroviral therapy, vast improvements in the life expectancy of individuals infected with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) were seen, and the liver disease of this population has become a leading cause of mortality. Although liver transplantation is as an effective treatment for end-stage liver disease, it remains in its nascent stage for the patients with HIV/AIDS in China, lacking standardized protocols and substantial clinical experience. Therefore, a “Multicenter expert consensus on perioperative management of liver transplantation in patients with human immunodeficiency virus infection” was formulated. This expert consensus aims to standardize and optimize the diagnosis and treatment process for liver transplantation in HIV-infected patients, providing systematic guidance for this procedure in China and fostering multidisciplinary collaboration and development in the field. This expert consensus clearly delineates the indications and contraindications for liver transplantation in HIV-infected patients, emphasizing comprehensive preoperative evaluations of both donors and recipients. These evaluations include infection control measures, immune function monitoring, and management of comorbidities. In terms of surgical procedures, strategies to prevent occupational exposure and intraoperative guidelines are outlined. Postoperatively, the focus is on antiviral therapy, individualized immunosuppression management, and vigilant monitoring of complications to ensure patient recovery and long-term survival. The long-term follow-up management prioritizes regular assessments of liver function, immune status, and HIV-related indicators to adjust treatment plans and enhance patient survival rates and quality of life. With the continuous enrichment of clinical experience and the progress of clinical research, this consensus will be continuously updated.
Liver transplantation is a most curative treatment for end-stage liver diseases. However, postoperative infection, especially the multi-drug resistant organisms infection, could contribute to the mortality after liver transplantation. Therefore, how to identify and prevent multi-drug resistant bacterial infection is the key to achieve improved postoperative outcomes after liver transplantation. The team of West China Hospital of Sichuan University, in collaboration with multiple Chinese medical centers, draw on the mature experiences of advanced countries in the field of transplantation jointly formulated the “Multicenter expert consensus on prevention and treatment of infections caused by multi-drug resistant organisms after liver transplantation”. The consensus had been developed around aspects such as epidemiological characteristics, antimicrobial uses, and prevention measurements of multi-drug resistant bacterial infection after liver transplantation.