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实体器官移植受者 2019 冠状病毒病的临床特征和免疫抑制剂治疗。

Clinical characteristics and immunosuppressant management of coronavirus disease 2019 in solid organ transplant recipients.

机构信息

Zhongnan Hospital of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center of Wuhan University, Hubei Key Laboratory of Medical Technology on Transplantation, Wuhan, Hubei, China.

Department of Cardiovascular Medicine, Wuchang Hospital of Wuhan University of Technology, Wuhan, Hubei, China.

出版信息

Am J Transplant. 2020 Jul;20(7):1916-1921. doi: 10.1111/ajt.15928. Epub 2020 May 4.

Abstract

Over 1 000 000 cases of coronavirus disease 2019 (COVID-19) have been confirmed since the worldwide outbreak began. Not enough data on infected solid organ transplant (SOT) recipients are available, especially data about the management of immunosuppressants. We report two cases of COVID-19 in two transplant recipients, with different treatments and prognoses. The first patient received liver transplantation due to hepatitis B virus-related hepatocellular carcinoma and was confirmed to have COVID-19 9 days later. Following a treatment regimen consisting of discontinued immunosuppressant use and low-dose methylprednisolone-based therapy, the patient developed acute rejection but eventually recovered. The other patient had undergone a renal transplant from a living-related donor 17 years ago, and was admitted to the hospital because of persistent fever. This patient was also diagnosed with COVID-19. His treatment regimen consisted of reduced immunosuppressant use. No signs of rejection were observed during the regimen. In the end, the patient successfully recovered from COVID-19. These effectively treated cases can provide a basis for immunosuppressant management of COVID-19-positive SOT recipients.

摘要

自全球疫情爆发以来,已确诊超过 100 万例 2019 年冠状病毒病(COVID-19)病例。目前有关感染实体器官移植(SOT)受者的数据不足,特别是有关免疫抑制剂管理的数据。我们报告了两例 COVID-19 移植受者的病例,他们的治疗和预后不同。第一例患者因乙型肝炎病毒相关肝细胞癌接受了肝移植,9 天后被确诊为 COVID-19。在停止使用免疫抑制剂和低剂量甲基强的松龙为基础的治疗方案后,患者发生了急性排斥反应,但最终康复。另一位患者在 17 年前接受了活体亲属供肾移植,因持续发热而住院。该患者还被诊断为 COVID-19。他的治疗方案包括减少免疫抑制剂的使用。在该方案期间未观察到排斥反应的迹象。最终,该患者成功从 COVID-19 中康复。这些成功治疗的病例可为 COVID-19 阳性 SOT 受者的免疫抑制剂管理提供依据。

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