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器官移植中供者来源传播的疾病
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- Author:
- No author available
- Journal Title:
- Chinese Journal of Organ Transplantation
- Issue:
- 3
- DOI:
- 10.3760/cma.j.issn.0254-1785.2013.03.002
- Key Word:
- No keyword available
Abstract： 器官移植中供者来源传播的疾病,一般是指病原体或肿瘤细胞来源于供者,通过移植器官传播给受者导致的疾病.实际情况中,并非所有疾病传播都会导致临床上的发病,这取决于病原体或肿瘤细胞的致病性和负荷量及受者的免疫抑制状态和易感性.即便是对于器官移植受者这种免疫功能异常的目标人群,易感的情况也并非是经常发生的.受感染的情况很多是由于临床意外发生的,在器官移植过程中,由于多种因素,如紧急切取器官缺乏术前筛查,疾病窗口期难以检出等的影响,使得受者感染供者来源的多种疾病无法避免.还有一些情况,是在移植前已知供者存在相关疾病,但受者急需得到器官来延续生命,或医疗上可以提供有效的手段来阻断或减少相关风险,在充分评估受者风险与获益的情况下,可以进行移植.目前的临床资料显示,供者传播给受者的疾病,包括肿瘤、病毒和细菌等病原体感染,发病后对受者的临床安全、移植器官的长期带功能存活以及移植免疫治疗方案的制订等,都有不良影响.当前病原体疾病谱发生了新的变化,而受到人类免疫识别系统及临床干预手段调整滞后性的制约,受者罹患移植物相关疾病的风险在升高.但总的来说,通过移植物传播的疾病,仍属于少见的病例,但由于其对受者的预后影响较大,因此需要在临床上给予相应的关注.
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