肾移植供者丙型肝炎病毒(HCV)感染状况及移植抗HCV阳性供肾对受者的影响  

The hepatitis C virus (HCV) infection status of donor and the impact of transplantation of kidneys from donors with anti-HCV antibody into recipients without anti-HCV

作　　者：姚亚成[1] 闵志廉[1] 朱有华[1] 

机构地区：[1]第二军医大学附属长征医院泌尿外科,上海200003

出　　处：《中华器官移植杂志》2001年第4期204-206,共3页Chinese Journal of Organ Transplantation

摘　　要：目的　了解肾移植供者丙型肝炎病毒 (HCV)的感染率及移植抗HCV阳性供肾对受者的影响。方法　采用酶联免疫吸附 (ELISA)法检测肾移植供、受者的抗HCV ;巢式多聚酶链反应(Nest PCR)法检测HCVRNA ;根据供、受者HCV状态将受者分为 4组 ,对各组受者进行 1年以上的随访研究。结果　 ( 1)供者HCV的感染率为 4 .3 5 % ;( 2 )抗HCV阴性的受者 ,接受抗HCV阳性供肾移植后 ,有 62 .5 %的抗HCV及HCVRNA转为阳性 ,术后丙氨酸转氨酶 (ALT)水平和肝功能损害发生率明显高于无HCV感染组 ;( 3 )将抗HCV阳性的供肾移植给抗HCV阳性的受者 ,与抗HCV阴性的受者接受抗HCV阳性供肾移植以及与抗HCV阳性的受者接受抗HCV阴性供肾的临床效果相同。结论　 ( 1)移植抗HCV阳性供肾能传播HCV ,可影响受者的肝脏病变 ,但这种影响程度较轻 ;( 2 )将抗HCV阳性供肾移植给抗HCV阳性的受者 ,既不增加传播HCV的危险性 ,又能扩大供肾来源 ,是解决我国供肾短缺的一项值得考虑的策略。Objectives To evaluate the rate of hepatitis C virus (HCV) infection in donor and the impact of transplantation of kidneys from donors with anti-HCV into recipients without anti-HCV.Methods Anti-HCV and HCV RNA of the sera from kidney donors and recipients were tested using second generation ELISA and Nest-PCR respectively. The recipients according to the HCV infection status were divided into 4 groups and followed up for more than one year.Results The rate of HCV infection in the donors was 4.35 %; Anti-HCV and HCV RNA of 62.5 % of the recipients became positive in the patients without anti-HCV who received kidneys withanti-HCV, and ALT levels and prevalence of liver dysfunction in these patients were significantly higher than those without HCV infection. The outcome of recipients with anti-HCV receiving kidneys with anti-HCV was the same as that of the patients with anti-HCV receiving kidneys without anti-HCV. Conclusions Transplantation of kidneys with anti-HCV can transmit HCV, and result in mild liver disease. It is a considerable way using kidneys from the anti-HCV positive donors in the anti-HCV positive recipients.

关 键 词：肾移植 供者 丙型肝炎病毒感染 受者 影响 

分 类 号：R699.2[医药卫生—泌尿科学]