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COVID-19 阳性供者的实体器官移植。

COVID-19 positive donor for solid organ transplantation.

机构信息

Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy.

Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria-ASST-Sette Laghi, Varese, Italy.

出版信息

J Hepatol. 2022 Oct;77(4):1198-1204. doi: 10.1016/j.jhep.2022.06.021. Epub 2022 Jul 4.

Abstract

The COVID-19 pandemic has significantly changed organ donation and transplantation worldwide. Since the beginning of the pandemic, the uncertainty regarding the potential route of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created tremendous pressures on transplantation communities, and international organisations have advised against using organs from deceased donors who have tested positive for SARS-CoV-2. The possibility of SARS-CoV-2 transmission through organ donation has only been reported for lung transplantation; hence, based on current experience, transplantation of non-lung organs from donors with active SARS-CoV-2 infection has been considered possible and safe, at least over short-term follow-up. As the evolving outbreak of SARS-CoV-2 continues, alongside the presence of vaccines and new treatment options, clinicians should consider transplanting organs from deceased donors with active SARS-CoV-2 infection to recipients with limited opportunities for transplantation and those with specific natural or vaccine-induced immunity. This article proffers an expert opinion on the use of organs from deceased donors with resolved or active SARS-CoV-2 infection in the absence of more definitive data and standardised acceptance patterns.

摘要

COVID-19 大流行极大地改变了全球的器官捐赠和移植。自大流行开始以来,关于严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)潜在传播途径的不确定性给移植界带来了巨大压力,国际组织建议不要使用 SARS-CoV-2 检测呈阳性的已故捐赠者的器官。目前仅报道了通过器官捐赠传播 SARS-CoV-2 的可能性;因此,根据目前的经验,从有 SARS-CoV-2 感染活动的供者移植非肺器官被认为是可能且安全的,至少在短期随访中是如此。随着 SARS-CoV-2 的不断爆发,以及疫苗和新的治疗选择的出现,临床医生应考虑将有 SARS-CoV-2 感染活动的已故供者的器官移植给移植机会有限且具有特定天然或疫苗诱导免疫力的受者。本文在缺乏更明确的数据和标准化接受模式的情况下,就使用已解决或有 SARS-CoV-2 感染的已故供者的器官提出了专家意见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a87/9251900/0ca1487207dc/gr1_lrg.jpg

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