Elderly recipients of hepatitis C positive renal allografts can quickly develop liver disease.
Elderly recipients of hepatitis C positive renal allografts can quickly develop liver disease.
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接受丙型肝炎阳性同种异体肾移植的老年接受者会很快患上肝病。
DOI：
10.1016/j.jss.2011.10.028
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
Brayman,KennethL
中科院分区：
文献类型：
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作者：
Flohr,TanyaR;Bonatti,Hugo;Hranjec,Tjasa;Keith,DougS;Lobo,PeterI;Kumer,SeanC;Schmitt,TimothyM;Sawyer,RobertG;Pruett,TimothyL;Roberts,JohnP;Brayman,KennethL
本机构探讨了使用携带丙型肝炎病毒（HCV）供体的同种异体移植用于老年人肾移植（RT）。2003年1月至2009年4月间，13例HCV -老年受体接受HCV+同种异体移植（eD+/R -）。90例老年HCV受体接受同种异体移植（eD - /R -）， 8例HCV+受体接受同种异体移植（D+/R+）， 13例HCV+受体接受同种异体移植（D - /R+）。中位随访时间为1.5年（0.8-5年）。7例eD+/R -出现HCV病毒载量阳性，6例肝转氨酶升高，活检显示为肝炎。总体而言，eD+/R -生存率为46%，eD - /R -生存率为85% （P = 0.003）。随访期间有7例eD+/R -死亡。病因包括多器官功能衰竭和败血症（n = 4）、癌症（n = 1）、无法茁壮成长（n = 1）和手术并发症（n = 1）。1例eD+/R -型患者死于与HCV感染直接相关的原因。总之，多发性eD+/R -迅速发展为hcv相关肝脏疾病，感染是常见的发病和死亡原因。
Our institution explored using allografts from donors with Hepatitis C virus (HCV) for elderly renal transplantation (RT). Thirteen HCV– elderly recipients were transplanted with HCV+ allografts (eD+/R–) between January 2003 and April 2009. Ninety HCV– elderly recipients of HCV– allografts (eD–/R–), eight HCV+ recipients of HCV+ allografts (D+/R+) and thirteen HCV+ recipients of HCV– allografts (D–/R+) were also transplanted. Median follow-up was 1.5 (range 0.8–5) years. Seven eD+/R– developed a positive HCV viral load and six had elevated liver transaminases with evidence of hepatitis on biopsy. Overall, eD+/R– survival was 46% while the eD–/R– survival was 85% (P = 0.003). Seven eD+/R– died during follow-up. Causes included multi-organ failure and sepsis (n = 4), cancer (n = 1), failure-to-thrive (n = 1) and surgical complications (n = 1). One eD+/R– died from causes directly related to HCV infection. In conclusion, multiple eD+/R– quickly developed HCV-related liver disease and infections were a frequent cause of morbidity and mortality.