Transplant Infectious Diseases, University of Alberta.
Infectious Diseases, University of Miami Miller School of Medicine.
Am J Transplant. 2010 Apr;10(4):889-899. doi: 10.1111/j.1600-6143.2009.02992.x. Epub 2010 Jan 29.
Nucleic acid testing (NAT) for HIV, HBV and HCV shortens the time between infection and detection by available testing. A group of experts was selected to develop recommendations for the use of NAT in the HIV/HBV/HCV screening of potential organ donors. The rapid turnaround times needed for donor testing and the risk of death while awaiting transplantation make organ donor screening different from screening blood-or tissue donors. In donors with no identified risk factors, there is insufficient evidence to recommend routine NAT, as the benefits of NAT may not outweigh the disadvantages of NAT especially when false-positive results can lead to loss of donor organs. For donors with identified behavioral risk factors, NAT should be considered to reduce the risk of transmission and increase organ utilization. Informed consent balancing the risks of donor-derived infection against the risk of remaining on the waiting list should be obtained at the time of candidate listing and again at the time of organ offer. In conclusion, there is insufficient evidence to recommend universal prospective screening of organ donors for HIV, HCV and HBV using current NAT platforms. Further study of viral screening modalities may reduce disease transmission risk without excessive donor loss.
核酸检测（NAT）可用于检测 HIV、HBV 和 HCV，从而缩短从感染到检测的时间。专家组选取了一批专家来制定 NAT 在 HIV/HBV/HCV 潜在器官供体筛查中的应用建议。由于需要快速周转时间来对供体进行检测，并且在等待移植期间存在死亡风险，因此器官供体筛查与血液或组织供体筛查不同。对于没有明确风险因素的供体，没有足够的证据推荐常规使用 NAT，因为 NAT 的益处可能并不大于其弊端，特别是当假阳性结果可能导致供体器官的损失时。对于具有明确行为风险因素的供体，应考虑使用 NAT 来降低传播风险并提高器官利用率。在候选者登记时以及在器官提供时，应通过知情同意来平衡供体源性感染的风险与继续留在候补名单上的风险。总之，目前使用的 NAT 平台没有足够的证据推荐对器官供体进行普遍的、前瞻性的 HIV、HCV 和 HBV 筛查。进一步研究病毒筛查方法可能会降低疾病传播风险，而不会导致过多的供体损失。
