Theodoropoulos N, Ladner D P, Ison M G
Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Department of Internal Medicine, Division of Infectious Diseases, The Ohio State University College of Medicine, Columbus, Ohio, USA; Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Transpl Infect Dis. 2013 Oct;15(5):545-9. doi: 10.1111/tid.12121. Epub 2013 Jul 31.
In 1994, the Public Health Service published guidelines to minimize the risk of human immunodeficiency virus (HIV) transmission and to monitor recipients following the transplantation of organs from increased-risk donors. A 2007 survey revealed the post-transplant surveillance of recipients of organs from increased-risk donors (ROIRD) is variable.
An electronic survey was sent to transplant infectious diseases physicians at US solid organ transplant centers.
A total of 126 surveys were sent to infectious diseases physicians, and we received 51 (40%) responses. We found that 22% of respondents obtain only verbal, 69% verbal and written, and 8% do not obtain any special consent from ROIRD, despite an Organ Procurement and Transplantation Network policy requiring such consent. Post-solid organ transplantation serologies for HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) are performed by 6-8% of respondents in all recipients, by 69% of respondents in ROIRD only, and 25% of respondents do not perform them at all. Post-transplant nucleic acid testing is carried out by 55-64% of respondents in ROIRD, by 0-2% in all recipients, and not performed by 35-43% of respondents.
Screening RIORD for HIV, HBV, and HCV has increased since 2007, but remains less than optimal and is incomplete when screening for disease transmission at many centers.
1994年，公共卫生服务部门发布了指导方针，以尽量降低人类免疫缺陷病毒（HIV）传播的风险，并在接受来自高风险捐赠者的器官移植后对受者进行监测。2007年的一项调查显示，对来自高风险捐赠者的器官移植受者（ROIRD）的移植后监测情况各不相同。
向美国实体器官移植中心的移植传染病医生发送了一份电子调查问卷。
共向传染病医生发送了126份调查问卷，收到51份（40%）回复。我们发现，尽管器官获取与移植网络政策要求获得此类同意，但22%的受访者仅获取口头同意，69%的受访者获取口头和书面同意，8%的受访者未从ROIRD处获得任何特殊同意。在所有受者中，6 - 8%的受访者对HIV、乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）进行实体器官移植后的血清学检测，仅在ROIRD中，69%的受访者进行此项检测，25%的受访者根本不进行检测。55 - 64%的受访者对ROIRD进行移植后核酸检测，在所有受者中，0 - 2%的受访者进行此项检测，35 - 43%的受访者未进行检测。
自2007年以来，对ROIRD进行HIV、HBV和HCV筛查的情况有所增加，但仍未达到最佳状态，并且在许多中心进行疾病传播筛查时并不完整。
