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目的 了解肾移植供者丙型肝炎病毒 (HCV)的感染率及移植抗HCV阳性供肾对受者的影响。方法 采用酶联免疫吸附 (ELISA)法检测肾移植供、受者的抗HCV ;巢式多聚酶链反应(Nest PCR)法检测HCVRNA ;根据供、受者HCV状态将受者分为 4组 ,对各组受者进行 1年以上的随访研究。结果 ( 1)供者HCV的感染率为 4 .3 5 % ;( 2 )抗HCV阴性的受者 ,接受抗HCV阳性供肾移植后 ,有 62 .5 %的抗HCV及HCVRNA转为阳性 ,术后丙氨酸转氨酶 (ALT)水平和肝功能损害发生率明显高于无HCV感染组 ;( 3 )将抗HCV阳性的供肾移植给抗HCV阳性的受者 ,与抗HCV阴性的受者接受抗HCV阳性供肾移植以及与抗HCV阳性的受者接受抗HCV阴性供肾的临床效果相同。结论 ( 1)移植抗HCV阳性供肾能传播HCV ,可影响受者的肝脏病变 ,但这种影响程度较轻 ;( 2 )将抗HCV阳性供肾移植给抗HCV阳性的受者 ,既不增加传播HCV的危险性 ,又能扩大供肾来源 ,是解决我国供肾短缺的一项值得考虑的策略。
Objective To investigate the infection rate of hepatitis C virus (HCV) in renal transplant recipients and the effect of transplanting anti-HCV positive donor on recipients. Methods HCV RNA was detected by enzyme-linked immunosorbent assay (ELISA) in nephropathy recipients and recipients. Nest PCR method was used to detect HCV RNA. According to HCV status of donor and recipient, the recipients were divided into 4 groups. Each group of patients for more than 1 year follow-up study. Results (1) The infection rate of HCV in donor was 4.55%. (2) After anti-HCV negative recipients receiving anti-HCV positive renal transplantation, 62.5% of the patients were positive for anti-HCV and HCVRNA, The postoperative ALT level and the incidence of liver dysfunction were significantly higher than those without HCV infection. (3) The anti-HCV positive donor recipients were transplanted with anti-HCV positive recipients and anti-HCV negative recipients The clinical effect of receiving an anti-HCV positive donor kidney transplant and receiving anti-HCV negative donor kidney recipients with an anti-HCV positive recipient is the same. Conclusions (1) Transplantation of anti-HCV positive donor kidneys can spread HCV, which may affect the liver lesions of recipients, but this effect is minor. (2) Anti-HCV positive donor kidney transplanted to HCV positive recipients neither Increasing the risk of transmission of HCV, but also to expand the source of supply of kidneys, is to solve our shortage of kidney supply a worthy strategy.