Roth D, Zucker K, Cirocco R, Burke G, Olson L, Esquenazi V, Miller J
Department of Medicine, University of Miami School of Medicine, Florida, USA.
Pediatr Nephrol. 1995;9 Suppl:S29-34. doi: 10.1007/BF00867680.
Hepatitis C virus (HCV) infection is the leading cause of post-transplant non-A, non-B hepatitis. Although many end-stage renal disease patients present for transplantation already infected with HCV, some recipients acquire the infection by transmission from the donor organ. We have detected serological evidence for HCV infection in 6.8% of our organ donors using second-generation anti-HCV assays. Approximately one-third of the patients who received an organ from a HCV carrier donor developed chronic transaminasemia and 8 of 14 (56%) patients converted from HCV RNA negative to positive in the posttransplant period. Demonstration of the course of viremia and transaminasemia is presented for 2 patients in whom transmission of HCV occurred. Using pulsatile machine perfusion, we were able to demonstrate that a standard perfusion of 20 h reduced the viral load in the kidney by 75%, additional flushes and a subsequent perfusion reduced the total viral titer by more than 99%. Thus, although transmission of HCV does occur with solid-organ transplantation, differences in the incidence of transmission between centers may be related to techniques of organ preservation.
丙型肝炎病毒（HCV）感染是移植后非甲非乙型肝炎的主要病因。尽管许多终末期肾病患者在接受移植时已感染HCV，但一些受者是通过供体器官传播而感染的。我们使用第二代抗HCV检测方法在6.8%的器官供体中检测到HCV感染的血清学证据。接受HCV携带者供体器官的患者中约有三分之一出现慢性转氨酶血症，14例患者中有8例（56%）在移植后从HCV RNA阴性转为阳性。本文展示了2例发生HCV传播患者的病毒血症和转氨酶血症病程。通过搏动性机器灌注，我们能够证明20小时的标准灌注可使肾脏中的病毒载量降低75%，额外冲洗及随后的灌注可使病毒总滴度降低超过99%。因此，尽管实体器官移植确实会发生HCV传播，但不同中心之间传播发生率的差异可能与器官保存技术有关。
