Liver Transplantation from Anti-Hepatitis C Virus-Positive Donors: Our Experience
Liver Transplantation from Anti-Hepatitis C Virus-Positive Donors: Our Experience
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DOI：
10.1016/j.transproceed.2012.05.012
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发表时间：
2012-07-01
影响因子：
0.9
通讯作者：
Jimenez, C.
中科院分区：
文献类型：
--
作者：
Alvaro, E.;Abradelo, M.;Jimenez, C.
背景丙型肝炎（HCV）是全球终末期肝病最常见的原因之一。供体短缺导致我们考虑替代器官来源，如HCV阳性供体。这些移植的结果必须进行彻底的评估，因为HCV阳性的肝移植受者中普遍存在疾病复发。从2005年1月至2011年4月，我们进行了143例肝移植（奥尔特）治疗继发于HCV感染的终末期肝病。13例患者（9.1%）接受了HCV阳性供体的肝脏。对照组由130例HCV阳性患者组成，他们在同一时期接受了奥尔特，器官来自HCV阴性。捐助者。通过2项检测评估供体HCV状态：HCV抗体和病毒载量。不仅分析了受体和移植物的存活率，还分析了肝炎复发的频率、时间和严重程度。在2005年1月1日至2011年4月30日的6年期间，在HCV阳性受者中进行了143例移植。9.1%的患者接受了来自抗HCV阳性供体的器官，其中72.7%的患者病毒载量为阴性。绝大多数（80%）患者在随访期间患有肝炎，其中22.4%为重症病例。两组间患者或移植物存活率无显著差异。HCV初始血清学阳性的移植物的高百分比显示没有病毒复制。来自HCV阳性供体的移植物可以被认为是一种安全，有效的肝脏捐赠来源。
Background. Hepatitis C (HCV) is among the most common causes of end-stage liver disease worldwide. The donor shortage leads us to consider alternative organ sources such as HCV-positive donors. The outcomes of these transplants must be evaluated thoroughly since there is universal recurrence of disease among HCV-positive liver transplant recipients.Methods. From January 2005 to April 2011, we performed 143 liver transplants (OLT) to treat end-stage liver disease secondary to HCV infection. Thirteen patients (9,1%) received livers from HCV-positive donors. A control group consisted of 130 HCV-positive patients who underwent OLT during the same period with organs from HCV-negative. donors. Donor HCV status was assessed by 2 tests: HCV antibodies and viral load. Not only recipient and graft survivals were analyzed, but also frequency, timing and severity of hepatitis recurrence.Results. Among 143 transplants performed in HCV-positive recipients during a 6-year period from January 1, 2005, to April 30, 2011,. 9.1% of patients received an organ from an anti-HCV-positive donor, 72.7% of whom showed a negative viral load. The vast majority (80%) of our patients suffered hepatitis during their follow-up, 22.4% of which were severe cases.Conclusions. No significant difference in patient or graft survival was observed between the 2 groups. A high percentage of grafts with initial positive serology for HCV showed no viral replication. Grafts from HCV-positive donors can be considered to be a safe, effective source for liver donation.