Li Andrew A, Cholankeril George, Cheng Xingxing S, Tan Jane C, Kim Donghee, Toll Alice E, Nair Satheesh, Ahmed Aijaz
Department of Medicine, Stanford University School of Medicine, Palo Alto, CA 94304, USA.
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA 94304, USA.
Diseases. 2018 Jul 10;6(3):62. doi: 10.3390/diseases6030062.
In recent years, the opioid epidemic and new hepatitis C virus (HCV) treatments have changed the landscape of organ procurement and allocation. We studied national trends in solid organ transplantation (2000⁻2016), focusing on graft utilization from HCV seropositive deceased donors in the pre-2014 (2000⁻2013) versus current (2014⁻2016) eras with a retrospective analysis of the United Network for Organ Sharing database. During the study period, HCV seropositive donors increased from 181 to 661 donors/year. The rate of HCV seropositive donor transplants doubled from 2014 to 2016. Heart and lung transplantation data were too few to analyze. A higher number of HCV seropositive livers were transplanted into HCV seropositive recipients during the current era: 374 versus 124 liver transplants/year. Utilization rates for liver transplantation reached parity between HCV seropositive and non-HCV donors. While the number of HCV seropositive kidneys transplanted to HCV seropositive recipients increased from 165.4 to 334.7 kidneys/year from the pre-2014 era to the current era, utilization rates for kidneys remained lower in HCV seropositive than in non-HCV donors. In conclusion, relative underutilization of kidneys from HCV seropositive versus non-HCV donors has persisted, in contrast to trends in liver transplantation.
近年来，阿片类药物流行和新型丙型肝炎病毒（HCV）治疗方法改变了器官获取与分配的格局。我们研究了实体器官移植的全国趋势（2000 - 2016年），通过对器官共享联合网络数据库进行回顾性分析，重点关注2014年前（2000 - 2013年）与当前（2014 - 2016年）时代来自HCV血清学阳性已故供体的移植物利用情况。在研究期间，HCV血清学阳性供体从每年181例增加到661例。从2014年到2016年，HCV血清学阳性供体移植率翻了一番。心脏和肺移植数据过少，无法进行分析。在当前时代，有更多HCV血清学阳性肝脏被移植到HCV血清学阳性受者体内：每年分别为374例和124例肝移植。肝移植的利用率在HCV血清学阳性和非HCV供体之间达到了平衡。虽然从2014年前时代到当前时代，移植到HCV血清学阳性受者体内的HCV血清学阳性肾脏数量从每年165.4例增加到334.7例，但HCV血清学阳性供体的肾脏利用率仍低于非HCV供体。总之，与肝移植趋势相反，HCV血清学阳性供体肾脏的相对利用不足情况仍然存在。
