Tzakis A G, Cooper M H, Dummer J S, Ragni M, Ward J W, Starzl T E
Department of Surgery, University Health Center of Pittsburgh, PA 15213.
Transplantation. 1990 Feb;49(2):354-8. doi: 10.1097/00007890-199002000-00025.
Twenty-five whole-organ recipients treated from 1981 through September 1988 were HIV carriers. Eleven were infected before transplantation, although this was not known until later in 8 recipients. The other 14 were infected perioperatively. Ten of the 25 recipients were infants or children. The organs transplanted were the liver (n = 15), and the heart or kidney (n = 5, each). After a mean follow-up of 2.75 years (range, 0.7-6.6 years), 13 recipients are alive. Survival is 7/15, 2/5, and 4/5 of the liver, heart, and kidney recipients, respectively. The best results were in the pediatric group (70% survival) in which only 1 of 10 patients died of AIDS. In contrast, AIDS caused the death of 5 of 15 adult recipients and was the leading cause of death. Transplantation plus immunosuppression appeared to shorten the AIDS-free time in HIV+ patients as compared to nontransplant hemophiliac and transfusion control groups. Accrual of HIV+ transplant recipients has slowed markedly since the systematic screening of donors, recipients, and blood products was begun in 1985.
1981年至1988年9月期间接受全器官移植的25名受者为艾滋病毒携带者。11名受者在移植前已被感染，不过其中8名受者直到后来才被发现。另外14名受者在围手术期被感染。25名受者中有10名是婴儿或儿童。移植的器官包括肝脏（n = 15）、心脏或肾脏（n = 5，各5例）。平均随访2.75年（范围0.7 - 6.6年）后，13名受者存活。肝脏、心脏和肾脏受者的存活率分别为7/15、2/5和4/5。最佳结果出现在儿科组（存活率70%），该组10名患者中只有1名死于艾滋病。相比之下，15名成年受者中有5名死于艾滋病，且艾滋病是主要死因。与未移植的血友病患者和输血对照组相比，移植加免疫抑制似乎缩短了艾滋病毒阳性患者的无艾滋病时间。自1985年开始对供者、受者和血液制品进行系统筛查以来，艾滋病毒阳性移植受者的累积数量已显著减少。
