Simonds R J
Division of HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, Georgia 30333.
AIDS. 1993 Nov;7 Suppl 2:S35-8. doi: 10.1097/00002030-199311002-00008.
Published reports in English of HIV infection in organ and tissue recipients were reviewed to examine (1) the effect of donor screening, allograft type, and allograft processing on risk of HIV transmission by transplantation; (2) the antibody response to HIV infection in organ recipients taking antirejection therapy; and (3) survival following transplantation for HIV-infected organ recipients.
Date of transplant, timing of HIV infection in relation to transplant, type of allograft, type of antirejection therapy, duration of follow-up, time to death, and time to antigen and antibody appearance were recorded for each of 32 reports.
HIV transmission associated with transplantation of kidney (n = 50), liver (n = 13), heart (n = 6), pancreas (n = 1), bone (n = 4), and skin (n = 1) has been reported. In all but 14 cases, transplantation occurred before routine donor screening for HIV antibody began. In addition, 24 cases of an organ transplant after the recipient became HIV-infected have been reported. Non-transmission of HIV from HIV-infected donors has also been reported in recipients of corneas (n = 9), bone (n = 26), other musculoskeletal tissue (n = 3), dura mater (n = 3), and kidneys (n = 2). Of 40 recipients with organ transplantation-associated infection who were tested for HIV antibody within 6 months of transplantation, 34 (85%) tested positive; only one recipient remained seronegative more than 6 months after transplantation. Estimated 1- and 5-year survival following transplantation for 61 HIV-infected kidney recipients was 90 and 50%, respectively.
With current screening practices, HIV transmission by transplantation is rare. The transmission risk appears lower for recipients of processed or avascular tissues. The antibody response to HIV infection in organ recipients taking immunosuppressive therapy is similar to that reported in other infected people.
回顾英文发表的关于器官和组织接受者感染人类免疫缺陷病毒（HIV）的报告，以研究：（1）供体筛查、同种异体移植物类型和同种异体移植物处理对移植传播HIV风险的影响；（2）接受抗排斥治疗的器官接受者对HIV感染的抗体反应；（3）HIV感染的器官接受者移植后的生存情况。
记录32篇报告中每一篇的移植日期、HIV感染相对于移植的时间、同种异体移植物类型、抗排斥治疗类型、随访时间、死亡时间以及抗原和抗体出现的时间。
已报告与肾移植（n = 50）、肝移植（n = 13）、心脏移植（n = 6）、胰腺移植（n = 1）、骨移植（n = 4）和皮肤移植（n = 1）相关的HIV传播。除14例外，所有移植均在常规供体HIV抗体筛查开始之前进行。此外，还报告了24例接受者在感染HIV后进行器官移植的病例。在角膜接受者（n = 9）、骨接受者（n = 26）、其他肌肉骨骼组织接受者（n = 3）、硬脑膜接受者（n = 3）和肾接受者（n = 2）中，也有关于未从感染HIV的供体传播HIV的报告。在移植后6个月内接受HIV抗体检测的40例与器官移植相关感染的接受者中，34例（85%）检测呈阳性；只有1例接受者在移植后6个多月仍为血清阴性。61例感染HIV的肾移植接受者移植后的1年和5年估计生存率分别为90%和50%。
按照目前的筛查方法，移植传播HIV的情况很少见。对于经过处理的或无血管组织的接受者，传播风险似乎较低。接受免疫抑制治疗的器官接受者对HIV感染的抗体反应与其他感染者的报告相似。
