Pancreas transplant outcomes in patients with human immunodeficiency virus infection

There is limited information on access and outcomes of patients living with human immunodeficiency virus (HIV) (PLWH) who have undergone pancreas transplantation. We conducted a retrospective cohort study analyzing data from the United Network for Organ Sharing from July 1, 2001, to June 30, 2021. Recipients of pancreas transplant were stratified by HIV serostatus. Graft and patient survival were analyzed using Kaplan-Meier product limit estimates. Multivariable Cox proportional hazard models were generated to identify factors associated with increased mortality or graft loss. Fifty PLWH and 16 380 patients without HIV underwent pancreas (with kidney) transplantation. PLWH were more often male (P < .001), Black/African American (P = .009), and on Medicare (P = .004). There were no significant differences in waiting time (P = .159) or proportion of patients treated for rejection within 1 year of transplant (P = .189) between groups. There were no differences in pancreas graft survival (P = .964) and overall patient survival (P = .250) between the cohorts. Dialysis status was negatively associated with graft survival. Although PLWH were more likely to represent a historically marginalized population, their outcomes after pancreas transplant were similar to their HIV-negative counterparts.