Hendele James B, Limaye Ajit P, Sibulesky Lena
Division of Transplant Surgery, Department of Surgery.
Division of Infectious Disease, Department of Medicine, University of Washington, Seattle, Washington, USA.
Curr Opin Organ Transplant. 2022 Apr 1;27(2):159-164. doi: 10.1097/MOT.0000000000000954.
To review and summarize the evolution of the Public Health Service (PHS) guidelines and Organ Procurement and Transplantation Network (OPTN) regulations for the prevention of blood borne virus transmission in solid organ transplant through the lens of popular culture, scientific evolution, patient and practitioner bias and outcomes research.
The most recent set of guidelines and regulations were released in 2020 and represent a culmination of decades of opinion, research and debate within the scientific and lay communities.
The guidelines were created to address public concern, and the risk of undiagnosed disease transmission in the context of the novel public health crisis of AIDS. We reviewed milestone publications from the scientific and lay press from the first description of AIDS in 1981 to the present to help illustrate the context in which the guidelines were created, the way they changed with subsequent editions, and offer critical consideration of issues with the current set of guidelines and a potential way forward. Further consideration should be given to the way in which the current guidelines identify donors with risk criteria for infectious disease transmission and mandate explanation of donor-specific risk factors to potential recipients, in our era of universal donor screening and recipient surveillance.
通过流行文化、科学发展、患者及从业者偏见以及结果研究等视角，回顾并总结公共卫生服务（PHS）指南和器官获取与移植网络（OPTN）法规在预防实体器官移植中血源病毒传播方面的演变。
最新的指南和法规于2020年发布，代表了科学界和普通大众数十年来观点、研究及辩论的成果。
这些指南旨在应对公众关切以及在艾滋病这一新型公共卫生危机背景下未确诊疾病传播的风险。我们回顾了从1981年首次描述艾滋病至今科学和大众媒体的里程碑式出版物，以帮助阐明指南制定的背景、后续版本的变化方式，并对当前指南的问题及潜在的前进方向进行批判性思考。在我们这个普遍进行供体筛查和受体监测的时代，应进一步考虑当前指南识别具有传染病传播风险标准的供体以及向潜在受体强制解释供体特定风险因素的方式。
