源自供者实体器官移植的受者感染

背景：目前,器官移植受者所面临的最大危险来自移植后感染。随着实体器官移植的广泛开展,器官来源严重短缺,大量边缘供者器官被采用,通过移植过程将供者的感染性疾病传播给受者的病例时有报道,其中包括一些罕见疾病的传播。2009年美国传染性疾病咨询委员会提出包括肿瘤在内的源自供者的传染性疾病的等级评判标准,为源自供者的受者感染性疾病的诊断提供了统一的标准。目的：综述国内外关于源自供者的实体器官移植受者感染性事件的研究概况。方法：应用计算机检索PubMed数据库、中国生物医学文献数据库、CNKI数据库及万方数据库2000-01/2010-01有关源自供者的实体器官移植受者感染性事件的文章,英文检索词为“transmission, organ transplantation”。中文检索词为“器官移植,供者,传染”。同时根据所获得的文献进行引文检索并对部分疾病进行补充检索。排除组织移植、不切题、重复或陈旧性文献。结果与结论：共保留48篇文献进一步分析。近10年来,源自供者的实体器官移植受者感染性事件的报道涉及细菌、病毒以及寄生虫传染,但绝大部分为罕见疾病的报道。源自供者的受者感染性事件的发生,无疑对目前广泛适用的供者筛查标准提出了挑战,但其毕竟只是小概率事件,并不影响器官移植的开展。

Donor-derived infections in solid organ transplantation recipients

BACKGROUND:At present, infection following transplantation is the greatest risk for recipients. With increasing development of organ transplantation, organ source is insufficient, and a large number of marginal donor organs have been used. Some infectious diseases are propagated to the recipients during transplantation, including some orphan diseases. In 2009, the assessment standards for donor-derived disease transmission were formulated by OPTN/UNOS Disease Transmission Advisory Committee, which provides uniform standards for the diagnosis of donor-derived disease transmission.OBJECTIVE:To summarize the literatures of donor-derived infections of solid organ transplantation recipients.METHODS:A computer-based online search of Pubmed database, Chinese Biomedical Literature Database, CNKI Database and Wanfang Database was performed to search articles related to donor-derived disease transmission published from January 2000 to January 2010 with the key words “transmission, organ transplantation” in English, and “organ transplantation, donor, transmission” in Chinese. According to references of collected literature, some studies of other diseases were included. Articles involving tissue transplantation, repetitive or outdated contents were excluded.RESULTS AND CONCLUSION: Finally, 48 articles were included. In the last decade, the case reports of donor-derived infections of solid organ transplantation recipients involved in the transmission of infections of bacteria, virus and parasite, most of them were about the infections of rare pathogen. For the incidence of the donor-derived infections, donor inclusive and exclusive criteria become important. However, the incidence of donor-derived infections is low, which would not hold-back the progress of organ transplantation.