Expanding access to transplantation with hepatitis C-positive donors: A new perspective on an old issue
Expanding access to transplantation with hepatitis C-positive donors: A new perspective on an old issue
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DOI：
10.1111/ctr.12884
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发表时间：
2017-02-01
影响因子：
2.1
通讯作者：
Sibulesky, Lena
中科院分区：
文献类型：
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作者：
Kling, Catherine E.;Limaye, Ajit P.;Sibulesky, Lena
随着器官的需求远远超过供应，以前暴露于乙肝B（HBV）和丙肝（HCV）病毒感染的供体应考虑移植。尽管许多中心都有将HBV核心抗体阳性（HBcAb+）供体的器官移植到选定的受体中的方案，但在直接作用抗病毒药物（DAA）时代，新的重点应该放在HCV阳性供体上。HCV抗体阳性（HCVAb+）核酸检测阴性（HCV NAT-）供体的传播率预计非常低，我们鼓励在提供正常活检、适当咨询和仔细的移植后监测的HCV受体中使用此类器官。虽然HCV NAT+供体的HCV传播是普遍的，但DAA在移植后受体中获得持续病毒应答的成功应使这些器官的使用更具吸引力。我们在此提供信息，以帮助指导使用来自HCV供体的器官。
With the need for organs far exceeding supply, donors previously exposed to hepatitis B (HBV) and hepatitis C (HCV) viral infections should be considered for transplantation. Although many centers have protocols for transplanting organs from HBV core antibody-positive (HBcAb+) donors into select recipients, in the era of direct-acting antivirals (DAAs), a new focus should be placed on HCV-positive donors. The transmission rate from HCV antibody-positive (HCVAb+) nucleic acid testing negative (HCV NAT-) donors is expected to be very low, and we encourage use of such organs in HCV recipients provided a normal biopsy, appropriate counseling, and careful post-transplant monitoring. While transmission of HCV from HCV NAT+ donors is universal, the success of DAA in obtaining a sustained viral response in post-transplant recipients should make the use of these organs more appealing. We herein provide information to help guide the use of organs from HCV donors.