Yale Universtiy, New Haven, Connecticut.
Northwestern University, Chicago, Illinois, USA.
Curr Opin Organ Transplant. 2018 Apr;23(2):257-263. doi: 10.1097/MOT.0000000000000504.
Strategies are needed to reduce waitlist mortality and increase transplantation rates. Advances in hepatitis C therapy has allowed the transplant community to look toward utilization of grafts from hepatitis C viremic donors to expand the organ pool. Use of such grafts for hepatitis C-negative patients is being evaluated and debated, and early trial data are emerging.
Both hepatitis C antibody-positive/nucleic acid test-negative and viremic donors are currently underutilized. Outcomes for viral hepatitis C (HCV) viremic transplant recipients are improving in the setting of direct-acting antiviral therapy. Optimization of graft utilization from HCV 'positive' donors and expansion to use of viremic donors for HCV-negative recipients will likely reduce waitlist mortality and result in net overall reduction in healthcare expenditures.
Herein, we provide a review of recent advancements relating to hepatitis C in solid organ transplant and outline future directions. A primary future focus will be data collection of outcomes of transplantation of grafts from HCV 'viremic' donors to nonviremic recipients in formal clinical trial protocols.
需要采取策略降低候补者死亡率和提高移植率。丙型肝炎治疗的进步使移植领域能够考虑利用丙型肝炎病毒血症供者的移植物来扩大器官库。正在评估和讨论此类移植物用于丙型肝炎阴性患者的情况，早期试验数据正在出现。
目前丙型肝炎抗体阳性/核酸检测阴性和病毒血症供者都未得到充分利用。在直接作用抗病毒治疗的背景下，丙型肝炎病毒（HCV）病毒血症移植受者的结局正在改善。优化来自 HCV“阳性”供者的移植物的利用并扩大对 HCV 阴性受者使用病毒血症供者，可能会降低候补者死亡率，并导致总体医疗支出的净减少。
总之，本文提供了一篇关于实体器官移植中丙型肝炎的最新进展的综述，并概述了未来的方向。未来的主要重点将是在正式临床试验方案中收集来自 HCV“病毒血症”供者的移植物移植给非病毒血症受者的结局数据。
