Roland Michelle E, Stock Peter G
Department of Medicine, University of California, Positive Health Program (AIDS Division) at San Francisco General Hospital, Ward 84, Building 80, 995 Potrero Avenue, San Francisco, CA 94110, USA.
Curr HIV/AIDS Rep. 2006 Sep;3(3):132-8. doi: 10.1007/BF02696657.
Recent policies, guidelines, and laws reflect promising preliminary outcomes among transplant recipients with HIV infection, and ethical analyses suggest that it is not justifiable to deny solid organ transplantation based solely on HIV-infection status. These studies consistently describe stable HIV disease following liver and kidney transplantation. Despite good graft survival, kidney allograft rejection occurs frequently, and serious non-AIDS-defining infections requiring hospitalization are common following antirejection therapy. Profound interactions between immunosuppressants and antiretroviral drugs require careful monitoring, dose adjustment, and highly effective communication between the patient and a multidisciplinary group of health care providers. Despite these scientific and policy advances, many health care providers and patients remain unaware of ongoing progress in this field. The implications are critical, as late referral for liver transplant evaluation increases the pretransplant mortality risk. Because important patient selection and clinical management questions remain, it is critical that ongoing studies are completed quickly.
近期的政策、指南和法律反映出感染艾滋病毒的移植受者取得了令人鼓舞的初步成果，伦理分析表明，仅基于艾滋病毒感染状况拒绝实体器官移植是不合理的。这些研究一致描述了肝移植和肾移植后艾滋病毒疾病的稳定情况。尽管移植物存活率良好，但肾移植排斥反应频繁发生，抗排斥治疗后需要住院治疗的严重非艾滋病定义感染很常见。免疫抑制剂和抗逆转录病毒药物之间的深刻相互作用需要仔细监测、剂量调整以及患者与多学科医疗保健团队之间的高效沟通。尽管有这些科学和政策进展，但许多医疗保健提供者和患者仍然不知道该领域的持续进展。其影响至关重要，因为肝移植评估延迟转诊会增加移植前死亡风险。由于重要的患者选择和临床管理问题仍然存在，尽快完成正在进行的研究至关重要。
