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成功治疗一名接受丙型肝炎阳性供体肾脏移植的丙型肝炎阳性患者:病例报告

Successful Treatment of a Hepatitis C-Positive Patient Who Received Kidney Transplant From a Hepatitis C-Positive Donor: A Case Report.

作者信息

Papayannis Ioannis, Patel P

机构信息

Division of Internal Medicine, Department of Medicine, Stony Brook University Hospital, Stony Brook, NY, USA

Division of Gastroenterology, Department of Medicine, Stony Brook University Hospital, Stony Brook, NY, USA.

出版信息

Prog Transplant. 2016 Sep;26(3):238-40. doi: 10.1177/1526924816654374. Epub 2016 Jun 9.

Abstract

Kidney transplantation from hepatitis C virus (HCV)-positive donors to HCV-positive recipients has always been controversial regarding the safety and the outcomes. In the posttransplant period, treatment of hepatitis C with interferon-based regimens could lead to serious side effects. A patient with chronic hepatitis C and nephropathy, on dialysis, underwent renal transplantation from an HCV-positive donor and received direct-acting antiviral (DAA) drugs thereafter. His renal and liver functions, as well as the hepatitis C viral load, were evaluated at predetermined intervals throughout and after his treatment. Patient's viral load was undetectable 4, 12, and 24 weeks after initiation of his treatment. Renal and liver functions were maintained at baseline, with no evidence of transplant rejection. Our clinical case is one of the few examples in the medical literature that shows successful suppression of replication of HCV in an HCV-infected kidney transplant candidate who received within 2 months of listing a deceased donor kidney transplant from an HCV-infected donor. The recipient was treated with DAAs, and this case illustrates potential safety and efficacy of this approach.

摘要

丙型肝炎病毒(HCV)阳性供体向HCV阳性受体进行肾移植在安全性和预后方面一直存在争议。在移植后阶段,基于干扰素的方案治疗丙型肝炎可能会导致严重的副作用。一名患有慢性丙型肝炎和肾病且正在接受透析的患者,接受了来自HCV阳性供体的肾移植,随后接受了直接抗病毒(DAA)药物治疗。在整个治疗过程及治疗后,按照预定的时间间隔对他的肾功能、肝功能以及丙型肝炎病毒载量进行了评估。治疗开始后4周、12周和24周时,患者的病毒载量均检测不到。肾功能和肝功能维持在基线水平,没有移植排斥的迹象。我们的临床病例是医学文献中为数不多的例子之一,显示了在一名HCV感染的肾移植候选者中,成功抑制了HCV的复制,该候选者在列入等待名单后2个月内接受了来自HCV感染供体的 deceased donor 肾移植。受体接受了DAA治疗,该病例说明了这种方法的潜在安全性和有效性。 (注:原文中“deceased donor”直译为“已故供体”,但在医学领域可能有更专业的表述,这里保留英文未翻译,因为不确定准确的专业术语)

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