丙型肝炎病毒感染与器官移植

Hepatitis C virus infection and organ transplantation

近年来,在器官移植候选者和受者中预防和治疗HCV的策略发展迅速。尽管HCV感染在肝或非肝实体器官移植中不再威胁移植结果,但它们仍然是研究的焦点。由于丙型肝炎仍然是全球因肝硬化失代偿期、肝衰竭和肝细胞癌而死亡的主要原因,因此需要合适的采取器官移植,以提高生存率和生活质量。而近年来随着HCV阳性实体器官供体的增加,且对器官的需求仍显著超过供应,随着直接抗病毒药物的发展,全球逐渐开展将HCV阳性供体器官移植到HCV阴性受体中,这将可能显著提高移植率并降低等候名单死亡率。目前抗HCV治疗的有效性创造了一个重要的机会,通过增加器官移植的可及性和降低候诊死亡率将显著提高终末器官衰竭患者的生存率。

In recent years,rapid progress has been made in strategies for the prevention and treatment of hepatitis C virus(HCV)in organ transplant candidates and recipients,and although HCV infections no longer threaten transplantation outcomes in liver or non-hepatic solid organ transplantation,they remain a focus of research.Since hepatitis C is still a leading cause of death worldwide due to decompensated cirrhosis,liver failure,and hepatocellular carcinoma,appropriate organ transplantation is needed to improve survival rate and quality of life.With the increase in HCV-positive solid organ donors in recent years and the fact that the demand for organs still greatly exceeds organ supply,as well as the development of direct-acting antiviral agents,transplantation of HCV-viraemic organs into HCV-naïve recipients will significantly increase transplantation rates and reduce waitlist mortality.The efficacy of current HCV therapies has created an important opportunity to improve the survival rate of patients with end-organ failure by enhancing access to organ transplantation and reducing waitlist mortality.