HIV阳性肾移植研究进展

Research progress on kidney transplantation in HIV-positive patients

人类免疫缺陷病毒(HIV)感染者容易出现肾功能不全,并可进展至终末期肾病(ESRD)。既往HIV阳性被认为是移植的绝对禁忌证,HIV阳性ESRD患者只能通过透析维持生命。随着医学的发展,国内外移植工作者尝试对HIV阳性患者进行肾移植。HIV阳性患者是否可接受肾移植,是否可以使用HIV阳性供肾进行移植,HIV阳性患者肾移植的效果如何也一直是移植界探讨的热点。本文就HIV相关性肾病、HIV阳性患者接受肾移植的条件、HIV阳性患者接受肾移植的效果、HIV阳性供肾的使用、HIV阳性患者免疫诱导药与术后免疫抑制药的使用进行探讨,以期为临床HIV阳性患者的肾移植、HIV阳性供肾的应用及HIV阳性患者肾移植术后的管理提供参考。

Patients infected with human immunodeficiency virus(HIV)are prone to renal insufficiency,which may progress into end-stage renal disease(ESRD).HIV infection has been previously considered as an absolute contraindication of transplantation.The lives of HIV-positive ESRD patients can only maintained through dialysis.With the development of medicine,transplantation practitioners at home and abroad attempt to perform kidney transplantation in HIV-positive patients.Whether kidney transplantation is feasible for HIV-positive patients,whether HIV-positive donor kidneys can be used for transplantation,and the efficacy of kidney transplantation for HIV-positive patients has always been hot topics in the field of transplantation.In this article,HIV-associated nephropathy,the conditions of kidney transplantation for HIV-positive patients,the efficacy of kidney transplantation for HIV-positive patients,use of HIVpositive donor kidneys,use of immune-inducing drugs and postoperative use of immunosuppressants for HIV-positive patients were illustrated,aiming to provide reference for kidney transplantation for HIV-positive patients in clinical practice,application of HIV-positive donor kidneys and postoperative management of HIV-positive patients.