Wits Donald Gordon Medical Centre, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, Johannesburg, 2193, South Africa.
Clinical HIV Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, Johannesburg, 2193, South Africa.
Curr HIV/AIDS Rep. 2019 Oct;16(5):404-413. doi: 10.1007/s11904-019-00460-7.
We review the international evolution of HIV and solid organ transplantation over 30 years. We emphasise recent developments in solid organ transplantation from HIV-infected to HIV-uninfected individuals, and their implications.
In 2017, Johannesburg, South Africa, a life-saving partial liver transplant from an HIV-infected mother to her HIV-uninfected child was performed. This procedure laid the foundation not only for consideration of HIV-infected individuals as living donors, but also for the possibility that HIV-uninfected individuals could receive organs from HIV-infected donors. Recent advances in this field are inclusion of HIV-infected individuals as living organ donors and the possibility of offering HIV-uninfected individuals organs from HIV-infected donors who are well-controlled on combination antiretroviral therapy (cART). The large number of HIV-infected individuals on cART is an unutilised source of otherwise eligible living organ donors. HIV-positive-to-HIV-negative organ transplantation has become a reality, providing possible new therapeutic options to address extreme organ shortages.
我们回顾了 30 多年来艾滋病毒和实体器官移植的国际发展。我们强调了最近从感染艾滋病毒者向未感染艾滋病毒者进行实体器官移植的最新进展及其影响。
2017 年,南非约翰内斯堡成功地进行了一次挽救生命的部分肝移植,由一名感染艾滋病毒的母亲捐给她未感染艾滋病毒的孩子。这一手术不仅为考虑将感染艾滋病毒者作为活体供体奠定了基础,也为未感染艾滋病毒者接受感染艾滋病毒供体器官的可能性奠定了基础。该领域的最新进展包括将感染艾滋病毒者纳入活体器官捐献者,以及为接受抗逆转录病毒联合疗法(cART)良好控制的感染艾滋病毒供体器官的未感染艾滋病毒者提供这种可能性。大量接受 cART 治疗的艾滋病毒感染者是未被利用的潜在活体器官捐献者来源。艾滋病毒阳性向艾滋病毒阴性的器官移植已成为现实,为解决极度器官短缺问题提供了可能的新治疗选择。