从使用乙型肝炎病毒核酸测试的经验教训 阳性供体对乙型肝炎疫苗接种肺移植候选人 (INHIBITOR) 研究
Andrew M Courtwright1, Stacey Prenner2, Jeffrey B Doyon3
1Division of Pulmonary and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
概括
这项试点研究使用B型肝炎病毒 (HBV) 核酸测试阳性 (NAT+) 捐赠者的肺部对接种疫苗 (sAb+) 接收者进行了探索. 严格的标准限制了入学,突出了利用这些器官进行肺移植的障碍.
科学领域:
- 移植免疫学 移植免疫学
- 在器官捐献中的传染病.
- 乙型肝炎病毒研究研究
背景情况:
- 试点研究调查从乙型肝炎病毒 (HBV) 核酸测试阳性 (NAT+) 捐赠者到HBV抗体阳性 (sAb+) 接受者的肺移植.
- 评估这种捐赠者-接受者战略的安全性和有效性.
- 在肺移植中识别使用NAT+捐献者的障碍.
研究的目的:
- 为了确定从HBV NAT+捐赠者到HBV sAb+候选者的肺移植的安全性和有效性.
- 报告研究经验和在利用NAT+捐赠者时遇到的障碍.
主要方法:
- 单中心试点研究设计.
- 资格标准:HBV sAb+,年龄<70岁,没有机械支,器官功能正常,cPRA<60岁.
- 捐赠者:脑死亡,没有边缘特征,没有同时存在的C型肝炎病毒 (HCV).
- 受益人接受了乙型肝炎免疫球蛋白和抗病毒疗法.
主要成果:
- 155名患者进行了查;64.5%的人排除了HBV sAb阴性.
- 在25名符合条件的sAb+候选人中,有13人被录取;6人被列为HBV NAT+器官.
- 由于质量或同时感染HCV,16个捐赠者报价被拒绝.
- 没有其他中心利用被拒绝的器官.
结论:
- 由于严格的资格标准,HBV免疫候选人不足以及严格的供体要求,入学人数有限.
- 需要进一步的研究来评估HBV NAT+供体肺移植的安全性和有效性.
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