TRANSPLANTATION OF KIDNEYS FROM DONORS WITH HEPATITIS-C ANTIBODY INTO RECIPIENTS WITH PRE-TRANSPLANTATION ANTI-HCV
TRANSPLANTATION OF KIDNEYS FROM DONORS WITH HEPATITIS-C ANTIBODY INTO RECIPIENTS WITH PRE-TRANSPLANTATION ANTI-HCV
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DOI：
10.1038/ki.1995.29
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发表时间：
1995-01-01
影响因子：
19.6
通讯作者：
PEREIRA, BJG
中科院分区：
文献类型：
--
作者：
MORALES, JM;CAMPISTOL, JM;PEREIRA, BJG
丙型肝炎病毒（HCV）是通过器官移植传播的。因此，一些器官采购组织已经暂停使用抗HCV阳性捐赠者的器官。由于供移植用的尸体肾脏供应不足，我们采取了将抗HCV供体的肾脏移植到抗HCV阳性受体的政策。在1990年3月至1992年12月期间，24例抗-HCV阳性透析患者接受了来自抗-HCV阳性供体的肾脏（I组），40例抗-HCV阳性患者接受了来自抗-HCV阴性供体的肾脏（II组）。我们比较了两组之间肝病的患病率、抗-HCV、HCV RNA、移植物和患者存活率。移植前I组24例患者中有17例（71%）和II组40例患者中有31例（79%）有血清HCV RNA。I组和II组的移植后随访时间分别为26 +/- 8个月和30 +/- 10个月。在随访期间，I组和II组分别有7/24（29%）和16/40（40%）例患者ALT水平升高（P > 0.05）。移植后，两组中的所有患者均保留了抗HCV。移植后HCVRNA阳性率I组为22/23例（96%），II组为30/39例（77%）（P > 0.05）。I组移植物和患者存活率（分别为96%和100%）与II组（分别为93%和98%）无显著差异。本研究的结果证明了抗HCV阳性受者使用抗HCV阳性供体肾脏的短期安全性。然而，这一政策可能无法防止HCV的传播。更安全的策略是将抗HCV阳性供体的肾脏移植到HCV RNA受体。
Hepatitis C virus (HCV) is transmitted by organ transplantation. Consequently, several organ procurement organizations have imposed a moratorium on use of organs from anti-HCV positive donors. Because of the inadequate supply of cadaver kidneys for transplantation, we adopted a policy to transplant kidneys from anti-HCV donors into anti-HCV positive recipients. During the period between March 1990 and December 1992, 24 anti-HCV positive dialysis patients received a kidney from anti-HCV positive donors (group I) and 40 anti-HCV positive patients received a kidney from anti-HCV negative donors (group II). We compared the prevalence of liver disease, anti-HCV, HCV RNA, graft and patient survival between groups. Pre-transplantation 17 of 24 (71%) patients in group I and 31 of 40 (79%) of patients in group II had serum HCV RNA. Post-transplantation follow-up was 26 +/- 8 months and 30 +/- 10 months in groups I and II, respectively. During follow-up, elevated ALT levels were present in 7 of 24 (29%) and 16 of 40 (40%) of patients in groups I and II, respectively (P > 0.05). Post-transplantation, all patients in both groups retained anti-HCV. The prevalence of HCV RNA post-transplantation was 22 of 23 (96%) patients in group I and 30 of 39 (77%) of patients in group II (P > 0.05). Graft and patient survival in group I(96% and 100%, respectively) were not significantly different from those in group II (93% and 98%, respectively). The results of this study demonstrate the short-term safety of using kidneys from anti-HCV positive donors in anti-HCV positive recipients. However, this policy may not prevent transmission of HCV. A safer strategy would be to transplant kidneys from anti-HCV positive donors into recipients with HCV RNA.