Am J Transplant:艾滋病患者适合作为肾脏捐献供体么?

2017-05-15 MedSci MedSci原创

最新修改的联邦法规已经允许艾滋病毒阳性个体为活肾捐献者;然而,鉴于与艾滋病毒感染相关的终末期肾病(ESRD)的风险增加,潜在的捐赠候选人知之甚少。

最新修改的联邦法规已经允许艾滋病毒阳性个体为活肾捐献者;然而,鉴于与艾滋病毒感染相关的终末期肾病(ESRD)的风险增加,潜在的捐赠候选人知之甚少。

为了更好地了解这一风险,该研究比较了41 968名艾滋病毒阳性参与者的ESRD发病率,参与者在北美艾滋病队列研究和设计协作平均随访时间为5年,并且收集了在国家卫生和营养检查III级对艾滋病毒阴性参与者平均随访时间为14年的数据。研究人员使用多变量Cox比例风险回归关联来推导所选艾滋病毒阳性情景(糖尿病高血压,艾滋病或丙型肝炎病毒合并感染史)的累积发病率估计值,并将这些估计值与来自同样选择的艾滋病毒阴性情况作对比分析。

对于具有健康特征的40岁艾滋病毒阳性个体与年龄匹配的肾脏供体相似,病毒载量<400拷贝/ mL,CD4计数≥500细胞/μL,ESRD累积发生率为9年(高于其艾滋病毒阴性的同龄人,但仍然很低):与白人妇女中的每10 000人中的1.1人相比艾滋病阳性个体为2.5,与白人男性中的每万人中有1.3人相比数据为3.0,相比黑人妇女中10 000人有10例的数据为13.2。

该研究表明,没有并发症和良好控制疾病的艾滋病毒阳性个体可能被认为是低风险的肾脏供体候选者。

原始出处:

A. D. Muzaale, et al. Risk of End-Stage Renal Disease in HIV-Positive Potential Live Kidney Donors. American Journal of Transplantation First published: March 2017

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    2018-03-10 xuyu
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    2017-07-14 feather85
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    2018-04-10 bsmagic9140
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