Rao Yannam Govardhana, Mirza D F
Liver Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
Natl Med J India. 2005 Jul-Aug;18(4):189-94.
There is an ever-increasing gap between the number of donors and those waiting for organ grafts, resulting in increased waiting times and mortality on transplant waiting lists. Consequently, every potential donor must be considered for possible transplantation even if they are outside the conventional donor criteria. To address this imbalance, organs are currently transplanted from living donors, older donors, haemodynamically unstable and non-heart-beating donors, and donors with prior infections. There is a potential to transmit infections and, to a lesser extent, malignancy from the donor organ to the immunosuppressed recipient, and this may also have an effect on subsequent organ function in the recipient. Thus, transmission of infections from organ donors to recipients represents low but serious potential risks that must be weighed against a candidate's risk of dying before a transplant becomes available.
器官捐献者的数量与等待器官移植者的数量之间的差距日益增大,导致等待时间延长,移植等待名单上的死亡率上升。因此,即使潜在捐献者不符合传统的捐献标准,也必须考虑将其作为可能的移植对象。为了应对这种不平衡,目前已开始使用活体捐献者、老年捐献者、血流动力学不稳定和非心脏跳动的捐献者以及曾有感染的捐献者的器官进行移植。存在将感染以及在较小程度上把恶性肿瘤从供体器官传播给免疫抑制受体的可能性,这也可能对受体随后的器官功能产生影响。因此,从器官供体向受体传播感染代表着低但严重的潜在风险,必须与候选者在获得移植前死亡的风险进行权衡。