在扩大的供体人群中传播疾病的风险：乙肝病毒供体的潜力

StephenW

Risk of disease transmission in an expanded donor population: the potential of hepatitis B virus donors
Kali Zhou  1 , Selena Zhou  2
Affiliations
Affiliations

    1
    Division of Gastrointestinal and Liver Diseases.
    2
    Department of Medicine, Keck School of Medicine at the University of Southern California, Los Angeles, California, USA.

    PMID: 33027191 DOI: 10.1097/MOT.0000000000000810

Abstract

Purpose of review: Lack of availability of donor organs is a constant challenge that patients and providers face in transplantation. To address this shortage, donors that test positive for hepatitis B, in particular those with resolved infection, have been increasingly utilized in clinical practice. We review here the potential risks for the recipient and the advances in hepatitis B management that have made use of these donors a well tolerated and advisable proposition.

Recent findings: As routine administration of antiviral prophylaxis in the posttransplant setting among those deemed high risk for transmission, outcomes for recipients of hepatitis B donors, including liver transplant recipients, have been comparable to uninfected donors. Universal hepatitis B nucleic acid testing of donors has also enhanced our ability to accurately inform recipients regarding transmission risk. Appropriate use of prophylaxis and careful monitoring for transmission posttransplant is key to ensuring no adverse outcomes occur.

Summary: Treatment of hepatitis B has evolved over the past two decades. Expanding the donor pool with hepatitis B donors is now well tolerated, ethical, and advantageous to the transplant community at large. A clear discussion with recipients on the substantial benefit and low harm of using hepatitis B donors will lead to greater acceptance and utilization of these organs.

StephenW

在扩大的供体人群中传播疾病的风险：乙肝病毒供体的潜力
周嘉莉1，周慧琳2
隶属关系
隶属关系

    1个
    胃肠道和肝脏疾病科。
    2
    美国南加州大学洛杉矶分校凯克医学院医学系。

    PMID：33027191 DOI：10.1097 / MOT.0000000000000810

抽象

审查目的：供体器官缺乏是患者和提供者在移植中面临的持续挑战。为了解决这一短缺问题，在临床实践中越来越多地使用了对乙型肝炎呈阳性的捐赠者，特别是那些感染被治愈的捐赠者。我们在这里回顾了接受者的潜在风险以及乙肝管理的进展，这些进展已经充分利用了这些捐赠者的耐受性和可取性。

最新发现：在被认为具有高传播风险的人群中，由于在移植后环境中常规给予抗病毒预防，乙肝捐赠者（包括肝移植接受者）的结局与未感染的捐赠者相当。捐献者的通用乙型肝炎核酸测试也增强了我们准确告知接受者有关传播风险的能力。适当使用预防措施并仔细监测移植后的传播是确保不发生不良后果的关键。

简介：在过去的二十年中，乙型肝炎的治疗有所发展。现在已经很好地容忍了乙型肝炎供体的供体库，这是合乎道德的，并且对整个移植界都有利。与接受者就使用乙型肝炎捐赠者的实质利益和低危害的明确讨论将使这些器官得到更大的接受和利用。