Detection of antibody to hepatitis C virus in renal transplant recipients.
Detection of antibody to hepatitis C virus in renal transplant recipients.
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肾移植受者丙型肝炎病毒抗体的检测。
DOI：
10.1097/00007890-199102000-00024
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发表时间：
1991
期刊：
影响因子：
6.2
通讯作者：
Miller,J
中科院分区：
文献类型：
--
作者：
Roth,D;Fernandez,JA;Burke,GW;Esquenazi,V;Miller,J
非甲非乙型肝炎是肾移植受者肝脏疾病的重要原因。为了评估丙型肝炎在一系列肾移植受者中的影响和患病率，我们回顾性地筛选了1979年至1989年期间移植的621例连续患者和484例在同一时间段内检索到的尸体器官供体，使用抗HCV抗体的酶联试验检测丙型肝炎病毒（HCV）感染的血清学证据。在596例HBsAg阴性患者中，180例（30%）在移植时抗-HCV阳性。移植后一年，117例（22%）有可检测水平的抗HCV抗体。在52/234例（22%）抗-HCV阳性患者中发生化学显著性肝炎，其中26例遵循与慢性肝炎一致的临床病程。在肝酶升高的组中，移植后1年可检测到HCV抗体的男性和患者明显更多。10年患者和移植物存活率分别为78%和50%，对于抗HCV阳性的丙氨酸转氨酶升高的患者，和76%和57%的队列维持正常的肝功能（P= NS）。抗-HCV阳性组和血清阴性组的患者和移植物存活率也没有差异。在484例有血清可供分析的尸体器官捐献者中（共1200例），67例（14%）在器官捐献时抗HCV阳性。在23个抗-HCV阴性的肾接受者中，接受了来自HCV抗体阳性供体的肾，只有一个在移植后1年发生血清转换。抗HCV抗体在肾移植受者和尸体器官捐献者中普遍存在。我们无法证明任何证据的长期不利影响的患者和移植物的生存抗HCV阳性患者采用第一代抗HCV检测。
Non-A, non-B hepatitis is a significant cause of liver disease among renal allograft recipients. In order to assess the impact and prevalence of hepatitis C in a series of renal allograft recipients, we retrospectively screened 621 consecutive patients transplanted between 1979 and 1989 and 484 cadaver organ donors retrieved in the same interval for serologic evidence of hepatitis C viral (HCV) infection using the enzyme-linked assay for anti-HCV antibody. Of 596 HBsAg negative patients, 180 (30%) were anti-HCV positive at the time of transplant. One-year posttransplant, 117 (22%) had detectable levels of anti-HCV antibody. Chemically significant hepatitis developed in 52/234 (22%) anti-HCV positive patients, and 26 of these followed a clinical course consistent with chronic hepatitis. Significantly more males and patients with antibody to HCV detectable at 1 year posttransplant were in the group experiencing an increase in liver enzymes. Ten-year patient and graft survival was 78% and 50%, respectively, for the anti-HCV positive patients who had an elevation of alanine aminotransferase, and 76% and 57% for the cohort maintaining normal liver function (P= NS). There were also no differences in patient and graft survival among the anti-HCV positive group and the consistently sero-negative patients. Of 484 cadaver organ donors with serum available for analysis (out of 1200 retrieved), 67 (14%) were anti-HCV positive at the time of organ donation. Among 23 anti-HCV negative kidney recipients who received a kidney from an HCV antibody positive donor, only one had seroconverted at 1 year posttransplant. Antibody to HCV appears to be widespread among renal transplant recipients and cadaver organ donors. We were unable to demonstrate any evidence of long-term adverse effects on patient and graft survival among anti-HCV positive patients employing the first generation anti-HCV assay.