Northwestern University, Chicago, IL.
Yale University, New Haven, CT.
Am J Transplant. 2017 Nov;17(11):2790-2802. doi: 10.1111/ajt.14381. Epub 2017 Jul 1.
The availability of direct-acting antiviral agents for the treatment of hepatitis C virus (HCV) infection has resulted in a profound shift in the approach to the management of this infection. These changes have affected the practice of solid organ transplantation by altering the framework by which patients with end-stage organ disease are managed and receive organ transplants. The high level of safety and efficacy of these medications in patients with chronic HCV infection provides the opportunity to explore their use in the setting of transplanting organs from HCV-viremic patients into non-HCV-viremic recipients. Because these organs are frequently discarded and typically come from younger donors, this approach has the potential to save lives on the solid organ transplant waitlist. Therefore, an urgent need exists for prospective research protocols that study the risk versus benefit of using organs for hepatitis C-infected donors. In response to this rapidly changing practice and the need for scientific study and consensus, the American Society of Transplantation convened a meeting of experts to review current data and develop the framework for the study of using HCV viremic organs in solid organ transplantation.
直接作用抗病毒药物的出现改变了丙型肝炎病毒 (HCV) 感染的治疗策略。这些变化通过改变终末期器官疾病患者的管理和接受器官移植的框架,影响了实体器官移植的实践。这些药物在慢性 HCV 感染患者中的高安全性和有效性为探索其在 HCV 病毒血症患者向非 HCV 病毒血症受者移植器官的应用提供了机会。由于这些器官经常被丢弃,而且通常来自年轻的供体,因此这种方法有可能在实体器官移植候补名单上挽救生命。因此,迫切需要前瞻性研究方案来研究使用 HCV 感染供体器官的风险与获益。为了应对这一快速变化的实践以及对科学研究和共识的需求,美国移植学会召集了一次专家会议,以审查现有数据并为研究 HCV 病毒血症器官在实体器官移植中的应用制定框架。