Impact of repeat testing of living kidney donors within 14 days of the transplant procedure: a multicenter retrospective survey.
Impact of repeat testing of living kidney donors within 14 days of the transplant procedure: a multicenter retrospective survey.
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移植手术后 14 天内重复检测活体肾捐献者的影响：多中心回顾性调查。
DOI：
10.1111/tid.12219
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Ison,MG
中科院分区：
文献类型：
--
作者：
Echenique,IA;Cohen,D;Rudow,DL;Ison,MG
背景一个人免疫缺陷病毒（HIV）从活体肾脏捐赠者的传播促使纽约州卫生部和美国疾病控制和预防中心建议所有活体捐赠者在捐赠程序的7-14天内进行额外的HIV、B肝炎病毒（HBV）和丙型肝炎病毒（HCV）筛查。有人担心，重新筛选将导致延迟和取消transplants.MethodsWe调查活体移植中心在纽约州，以评估他们的筛选协议和结果。九个活供体程序（肾脏和肝脏中心）responded.ResultsAll，但1个程序有一个正式的重复筛选政策。总体而言，未发生取消，但2家临床试验机构发生了移植延迟，通常是由于技术人员和实验室程序错误导致需要重复采血。测试通常与术前访视、额外的实验室检查和体格检查相协调。在初始评价中，最常使用血清学（所有9家中心），很少有中心使用核酸检测（NAT）（HIV NAT，1; HBV NAT，2; HCV NAT，2）。重复测试模式各不相同：HIV抗体（5，55%）、HIV NAT（8，88%）、乙型肝炎B表面抗原（5，55%）、乙型肝炎B表面抗体（2，22%）、乙型肝炎B核心抗体（3，33%）、HBV NAT（3，33%）、HCV抗体（3，33%）和HCV NAT（5，结论大多数受访者有政策在移植手术后14天内重新测试活体供体。临床试验机构很少遇到重复检测相关延迟，但没有发生取消。
BackgroundA transmission of human immunodeficiency virus (HIV) from a live kidney donor prompted recommendations by the New York State Department of Health and the US Centers for Disease Control and Prevention that all live donors undergo additional screening for HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) within 7–14 days of the donation procedure. There are concerns that re‐screening will result in delays and cancelled transplants.MethodsWe surveyed live‐donor transplant centers in New York State to assess their screening protocols and outcomes. Nine live‐donor programs (kidney and liver centers) responded.ResultsAll but 1 program has a formal repeat screening policy. Overall, no cancellations occurred, but 2 centers experienced transplantation delays, generally as the result of technician and laboratory procedural mistakes necessitating repeat phlebotomy. Testing is typically coordinated with pre‐surgical visits, additional laboratory tests, and physical examinations. In the initial evaluation, serology was most frequently used (all 9 centers), with few centers utilizing nucleic acid testing (NAT) (HIV NAT, 1; HBV NAT, 2; HCV NAT, 2). Repeat testing modalities varied: HIV antibody (5, 55%), HIV NAT (8, 88%), hepatitis B surface antigen (5, 55%), hepatitis B surface antibody (2, 22%), hepatitis B core antibody (3, 33%), HBV NAT (3, 33%), HCV antibody (3, 33%), and HCV NAT (5, 55%).ConclusionMost respondents have policies to re‐test living donors within 14 days of the transplant procedures. Rarely, centers encountered repeat testing‐associated delays, but no cancellations occurred.