Hepatitis E virus infection in the liver transplant recipients:Clinical presentation and management

Hepatitis E virus(HEV) is an emerging pathogen and an increasingly recognized cause of graft hepatitis, especially in the post-orthotopic liver transplantation immunocompromised population. The exact incidence and prevalence of HEV infection in this population remains unclear but is certainly greater than historical estimates. Identifying acute HEV infection in this population is imperative for choosing the right course of management as it is very difficult to distinguish histologically from acute rejection on liver biopsy. Current suggested approach to manage acute HEV involves modifying immunosuppression, especially discontinuing calcineurin inhibitors which are the preferred immunosuppressive agents post-orthotopic liver transplantation. The addition of ribavirin monotherapy has shown promising success rates in clearing HEV infection and is used commonly in reported cases.

中国器官捐献的发展历程

中国的器官捐献与移植经历了一个漫长而坎坷的发展历程。在国家卫生和计划生育委员会以及中国红十字会总会领导下,经过十年的不懈努力,初步形成了一个遵循世界卫生组织指导原则并符合中国国情的器官捐献移植体系,开始了一个以公民自愿捐献为唯一来源的历史发展新阶段。但中国的器官捐献与移植体系还是一个新生的婴儿,需要逐步成长及完善。而重症医学作为器官捐献的主要参与学科,涉及到捐献体系中的诸多关键环节。

中国心脏死亡捐献器官评估与应用专家共识（2014版）

自2010年原卫生部启动人体器官捐献工作以来，经过各界努力，目前人体器官捐献尤其是心脏死亡器官捐献（ donation after cardiac death, DCD），在全国范围内已得到广泛开展。亟待制订相关专家共识来指导全国DCD器官的质量评估，推动其在临床上更规范、有效、安全地应用。中华医学会器官移植学分会、中华医学会外科学分会移植学组及中国医师协会器官移植医师分会组织专家制订了《中国心脏死亡捐献器官评估与应用专家共识（2014版）》，重点阐述了中国DCD与心脏死亡诊断标准、器官获取、DCD器官在肝移植和肾移植中的评估和应用以及移植受者围术期的特殊干预。