Prognosis for HIV positive patients dramatically improved after the introduction of the Highly Active Anti-Retroviral Treatment (HAART) drug regimen (1). Following recent reports 50% of HIV positive patients die for an end stage liver disease: cirrhosis or Hepatocellular carcinoma (HCC) (2). For these rea- sons an increasing number of HIV positive patients with related hepatic disease refer to centres of hepato- biliary surgery and transplantation. The aim of this study was to evaluate surgical options for this popula- tion with particular regard to liver resection or liver transplantation. The liver transplantation was planned according to the designed protocol for a pilot program (PP) approved by the National AIDS Committee and by the Regulatory Agency of the Italian Ministry of Health (3). The most important co-morbidities were recorded and analysed. Patients and methods Data of the HIV positive patients who referred to our liver unit from January 2002 to September 2003 have been retrospectively reviewed. The underlying liver diseases, the routes of the viral infection trans- mission and the related coinfections were recorded. Demographic data and therapeutic pathway were analysed. Among the patients considered for surgery, the kind of surgical resection, the time required for the surgical procedure, the length of portal clamping J. Exp. Clin. Cancer Res., 22, 4, 2003 - Supplement 167 Resection and Transplantation: Evaluation of Surgical Perspectives in HIV Positive Patients Affected by End-Stage Liver Disease Ettorre G.M., Vennarecci G., Boschetto A., Giovannelli L., Antonini M. 1 , Carboni F., Santoro R., Lepiane P., Cosimelli M., Lonardo M. T., Del Nonno F. 2 , Perracchio L. 2 , Maritti M. 1 , Moricca P. 1 , D’Offizi G. 3 , Narciso P. 3 , Noto P. 3 , Boumis E. 3 , Petrosillo N. 3 , Visco G., Santoro E. Department of Digestive Surgery and Liver Transplantation, 1 Department of Anaesthesiology and Intensive Care, 2 Department of Pathology, IRCCS “Regina Elena” Cancer Institute, Department of Infectious Disease IRCCS INMI 3 “L. Spallanzani”; Rome, Italy Purpose The aim of this study was to evaluate the opportunity of surgical treatment in terms of liver resection or liver transplantation in HIV positive patients affected by an end stage liver disease that referred to our liver unit. Methods Among 1350 outpatients who referred to our liver unit from January 2002 to September 2003, thirty- two (2,4%) were HIV positive. The routes of transmission of the viral infection, the related co-infections and the underlying liver disease were recorded. The therapeutic pathway was analysed. The kind and the duration of the surgical procedures were assessed. Results Fourteen (44%) of these thirty-two patients were not suitable for surgical treatment. Surgery was planned in 9 of 32 HIV positive patients (28%). Four patients (12%) were submitted to liver resection and OLT was per- formed in five patients (15%). Hepatocellular Carcinoma was present in 4 (44%) of the HIV positive patients considered for surgery. Conclusions In conclusion in our centre the 28% of HIV positive out patients had the opportunity to receive a surgical treatment. The candidate to this surgery is mostly young, HCV and/or HBV coinfected and affected by HCC in 44% of cases. Key Words: liver resection, liver transplantation, HIV positive patients