Outcomes Among Children Who Received a Kidney Transplant in the United States From a Hepatitis B Core Antibody-Positive Donor, 1995-2010.
Outcomes Among Children Who Received a Kidney Transplant in the United States From a Hepatitis B Core Antibody-Positive Donor, 1995-2010.
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1995 年至 2010 年在美国接受乙型肝炎核心抗体阳性捐赠者肾脏移植的儿童的结果。
DOI：
10.1093/jpids/piv070
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发表时间：
2016
影响因子：
3.2
通讯作者：
Laskin,BenjaminL
中科院分区：
文献类型：
--
作者：
Ruebner,RebeccaL;Moatz,Taylor;Amaral,Sandra;Reese,PeterP;Blumberg,EmilyA;Smith,JodiM;Danziger-Isakov,Lara;Laskin,BenjaminL
背景接受有B型肝炎病毒感染史的供者的肾脏进行移植可能会增加终末期肾病患者的器官可用性。在成人受者中，来自B型肝炎病毒核心抗体阳性供体的肾移植导致了良好的移植物和患者存活率。然而，儿科器官移植受者的免疫系统正在发育，感染并发症的风险高于成人。因此，很少有人知道的结果，儿童谁收到了肾移植从一个肝炎B病毒核心抗体阳性donator.MethodsWe包括11 898名儿童≤18岁谁收到了第一次肾移植在美国之间的1995年1月1日，2010年12月31日，谁被记录在移植受体的科学登记。我们研究了从B型肝炎病毒核心抗体阳性donor.ResultsThere的肾移植的儿童之间的移植物和患者的存活率的差异，有199名儿童（1.7%）谁收到了从B型肝炎病毒核心抗体阳性供体肾移植。超过80%的移植发生在B型肝炎病毒核心抗体和表面抗原阴性的受者中。经过7.9年的中位随访，调整后的移植物无显著差异（风险比[HR]，1.03 [95%置信区间（CI），0.80-1.31]）或患者（HR，1.12 [95%CI，0.73-1.73]）根据供体核心抗体状态的存活率。考虑将B型肝炎病毒核心抗体阳性供体用于终末期肾病血清保护儿童的肾移植。
BackgroundAccepting kidneys for transplant from donors with a history of hepatitis B virus infection may increase the availability of organs for those with end-stage kidney disease. In adult recipients, kidney transplants from hepatitis B virus core antibody–positive donors have resulted in favorable graft and patient survival rates. However, pediatric organ transplant recipients have developing immune systems and a higher risk of infectious complications than adults. Accordingly, little is known about the outcomes of children who have received a kidney transplant from a hepatitis B virus core antibody–positive donor.MethodsWe included 11 898 children ≤18 years of age who received a first kidney transplant in the United States between January 1, 1995, and December 31, 2010, and who were recorded in the Scientific Registry of Transplant Recipients. We examined differences in graft and patient survival rates among children who received a kidney transplant from a hepatitis B virus core antibody–positive donor.ResultsThere were 199 children (1.7%) who received a kidney transplant from a hepatitis B virus core antibody–positive donor. More than 80% of these transplants occurred in recipients who were hepatitis B virus core antibody and surface antigen negative. After a median follow-up of 7.9 years, there were no significant differences in the adjusted graft (hazard ratio [HR], 1.03 [95% confidence interval (CI), 0.80–1.31]) or patient (HR, 1.12 [95% CI, 0.73–1.73]) survival rates according to donor core antibody status.ConclusionsIt may be acceptable, on a case-by-case basis, to consider hepatitis B virus core antibody–positive donors for kidney transplants to seroprotected children with end-stage kidney disease.
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