肺和心脏移植接受者的结核病
María Asunción Pérez-Jacoiste Asín1, Francisco López-Medrano1,2,3, José María Aguado1,2,3
1Unit of Infectious Diseases, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Madrid, Spain.
JHLT open
|November 28, 2025
概括
固体器官移植接受者,特别是肺和心脏接受者,由于免疫抑制,面临结核病 (TB) 重新激活的高风险. 早期查和量身定制的治疗对于这些脆弱患者的结核病管理至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 移植医学 移植医学
- 免疫学 免疫学 免疫学
背景情况:
- 结核菌 (TB) 是固体器官移植 (SOT) 接受者的主要机会性病原体.
- 移植存活所需的慢性免疫抑制增加了结核病复激活的风险,特别是在肺和心脏移植接受者中.
- 献体结核病带来很大的风险,特别是在肺移植中.
研究的目的:
- 审查SOT受益人结核病查和管理的挑战和策略.
- 强调移植前结核病查对捐赠者和接受者的重要性.
- 讨论这种免疫受损人群的诊断和治疗复杂性.
主要方法:
- 文献综述侧重于肺和心脏移植接受者的结核病.
- 分析由于免疫抑制和非典型表现的诊断挑战.
- 检查治疗复杂性,包括药物相互作用和关于新疗法的有限数据.
主要成果:
- 接受SOT的患者,特别是肺和心脏患者,患结核病再激活和输血结核病的风险较高.
- 诊断因免疫抑制诱导的非典型症状和更高的肺外/传播性结核病率而复杂化.
- 由于药物相互作用和缺乏证据,治疗是具有挑战性的,因为在这个人群中缺乏新的结核病药物.
结论:
- 对捐赠者和接受者进行移植前结核病查对于SOT接受者至关重要.
- 及时诊断和适当的管理协议对于改善结果至关重要.
- 需要对结核病治疗方案进行进一步的研究,特别是对多药性结核病的多药性结核病,在移植接受者中.
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