留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

新型冠状病毒感染者器官捐献专家共识

中华医学会器官移植学分会, 中国医师协会器官移植医师分会, 国家人体捐献器官获取质量控制中心. 新型冠状病毒感染者器官捐献专家共识[J]. 器官移植, 2023, 14(1): 1-10. doi: 10.3969/j.issn.1674-7445.2023.01.001
引用本文: 中华医学会器官移植学分会, 中国医师协会器官移植医师分会, 国家人体捐献器官获取质量控制中心. 新型冠状病毒感染者器官捐献专家共识[J]. 器官移植, 2023, 14(1): 1-10. doi: 10.3969/j.issn.1674-7445.2023.01.001
Branch of Organ Transplantation of Chinese Medical Association, Branch of Organ Transplant Physician of Chinese Medical Doctor Association, National Quality Control Center for Human Donated Organ Procurement. Expert consensus on organ donation from patients infected with novel coronavirus in China[J]. ORGAN TRANSPLANTATION, 2023, 14(1): 1-10. doi: 10.3969/j.issn.1674-7445.2023.01.001
Citation: Branch of Organ Transplantation of Chinese Medical Association, Branch of Organ Transplant Physician of Chinese Medical Doctor Association, National Quality Control Center for Human Donated Organ Procurement. Expert consensus on organ donation from patients infected with novel coronavirus in China[J]. ORGAN TRANSPLANTATION, 2023, 14(1): 1-10. doi: 10.3969/j.issn.1674-7445.2023.01.001

新型冠状病毒感染者器官捐献专家共识

doi: 10.3969/j.issn.1674-7445.2023.01.001
基金项目: 

国家医学中心辅导类——陕西省科技厅两链融合项目 2021LL-JB-06(3.4,3.5)

国家自然科学基金项目 82070768

国家重大疾病多学科合作诊疗能力建设项目 陕卫办医函〔2019〕485号

中国器官移植发展基金会“菁英计划” 2019JYJH04

详细信息
  • 中图分类号: R617, R373.1

Expert consensus on organ donation from patients infected with novel coronavirus in China

  • 摘要: 新型冠状病毒(新冠病毒)感染疫情传播、防控和新冠病毒从捐献者传播到受者的潜在风险及其不确定性等,给器官捐献和移植工作带来严重影响和巨大挑战。越来越多的证据表明使用来自新冠病毒感染的捐献者非肺脏器官(肾脏、肝脏和心脏)无论在获取时是否存在症状,传播的风险都很低。推迟新冠病毒抗原或核酸检测阳性者逝世后的器官捐献时间,待病毒检测阴性后再行捐献,将导致相当数量医学上适合移植的器官丢失。为最大限度满足终末期器官衰竭患者移植就医需求,中华医学会器官移植学分会组织相关专家,结合国内新冠病毒感染流行形势及器官捐献和移植工作的临床实践,参考国内外相关研究结果及临床研究证据制定了公民逝世后器官捐献《新型冠状病毒感染者器官捐献专家共识》,旨在为新冠病毒感染者捐献器官的获取和应用提供建议和参考。

     

  • 图  1  新冠病毒感染者非肺脏器官捐献流程图

    Figure  1.  Flow chart of non-pulmonary organ donation of donors infected with novel coronavirus

    图  2  新冠病毒感染捐献者肺脏捐献流程图

    Figure  2.  Flow chart of pulmonary donation of donors infected with novel coronavirus

  • [1] AUBERT O, YOO D, ZIELINSKI D, et al. COVID-19 pandemic and worldwide organ transplantation: a population-based study[J]. Lancet Public Health, 2021, 6(10): e709-e719. DOI: 10.1016/S2468-2667(21)00200-0.
    [2] RITSCHL PV, NEVERMANN N, WIERING L, et al. Solid organ transplantation programs facing lack of empiric evidence in the COVID-19 pandemic: a By-proxy Society Recommendation Consensus approach[J]. Am J Transplant, 2020, 20(7): 1826-1836. DOI: 10.1111/ajt.15933.
    [3] PEGHIN M, GROSSI PA. COVID-19 positive donor for solid organ transplantation[J]. J Hepatol, 2022, 77(4): 1198-1204. DOI: 10.1016/j.jhep.2022.06.021.
    [4] BOCK MJ, VAUGHN GR, CHAU P, et al. Organ transplantation using COVID-19-positive deceased donors[J]. Am J Transplant, 2022, 22(9): 2203-2216. DOI: 10.1111/ajt.17145.
    [5] DHAND A, OKUMURA K, NABORS C, et al. Solid organ transplantation from COVID positive donors in the United States: analysis of United Network for Organ Sharing database[J]. Transpl Infect Dis, 2022, DOI: 10.1111/tid.13925[Epub ahead of print].
    [6] 国家卫生健康委办公厅, 中央军委后勤保障部卫生局. 血站新冠病毒感染防控工作指引(第二版)[EB/OL]. [2023-01-05]. http://www.nhc.gov.cn/ylyjs/pqt/202212/2320f33915664959b868d3ac49b91c1c.shtml.
    [7] MARTINEZ-REVIEJO R, TEJADA S, CIPRIANO A, et al. Solid organ transplantation from donors with recent or current SARS-CoV-2 infection: a systematic review[J]. Anaesth Crit Care Pain Med, 2022, 41(4): 101098. DOI: 10.1016/j.accpm.2022.101098.
    [8] SCHOLD JD, KOVAL CE, WEE A, et al. Utilization and outcomes of deceased donor SARS-CoV-2-positive organs for solid organ transplantation in the United States[J]. Am J Transplant, 2022, 22(9): 2217-2227. DOI: 10.1111/ajt.17126.
    [9] 国务院应对新型冠状病毒肺炎疫情联防联控机制综合组. 关于进一步优化新冠肺炎疫情防控措施科学精准做好防控工作的通知[A/OL]. [2023-01-05]. http://www.nhc.gov.cn/xcs/zhengcwj/202211/ed9d123bbfe14e738402d846290049ea.shtml.
    [10] 国务院应对新型冠状病毒肺炎疫情联防联控机制综合组. 关于进一步优化落实新冠肺炎疫情防控措施的通知[EB/OL]. [2023-01-05]. http://www.nhc.gov.cn/xcs/zhengcwj/202212/8278e7a7aee34e5bb378f0e0fc94e0f0.shtml.
    [11] 国家卫生健康委. 公告[EB/OL]. [2023-01-05]. http://www.nhc.gov.cn/xcs/zhengcwj/202212/6630916374874368b9fea6c2253289e1.shtml.
    [12] 国务院应对新型冠状病毒肺炎疫情联防联控机制综合组. 关于对新型冠状病毒感染实施"乙类乙管"的总体方案[EB/OL]. [2023-01-05]. http://www.nhc.gov.cn/xcs/zhengcwj/202212/e97e4c449d7a475794624b8ea12123c6.shtml.
    [13] 国家卫生健康委办公厅, 国家中医药局综合司. 关于印发新型冠状病毒感染诊疗方案(试行第十版)的通知[A/OL]. [2023-01-06]. http://www.gov.cn/zhengce/zhengceku/2022-03/15/content_5679257.htm.
    [14] WANG Q, IKETANI S, LI Z, et al. Alarming antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants[J]. Cell, 2022, DOI: 10.1016/j.cell.2022.12.018[Epub ahead of print].
    [15] CALLAWAY E. Heavily mutated Omicron variant puts scientists on alert[J]. Nature, 2021, 600(7887): 21. DOI: 10.1038/d41586-021-03552-w.
    [16] 中国疾控中心病毒病所, 中国疾病预防控制中心. 关于XBB. 1.5毒株, 这些知识您需要了解[EB/OL]. [2023-01-07]. https://www.chinacdc.cn/jkzt/crb/zl/szkb_11803/jszl_2275/202301/t20230104_263205.html.
    [17] 陶焱炀, 王哲, 孙昼, 等. 奥密克戎变异株引起的新型冠状病毒肺炎流行病学分析[J]. 国际流行病学传染病学杂志, 2022, 49(5): 314-319. DOI: 10.3760/cma.j.cn331340-20220708-00153.

    TAO YY, WANG Z, SUN Z, et al. Analysis on the epidemic of COVID-19 caused by Omicron variant in Hangzhou[J]. Intern J Epidemiol Infect Dis, 2022, 49(5): 314-319. DOI: 10.3760/cma.j.cn331340-20220708-00153.
    [18] VAN DOREMALEN N, BUSHMAKER T, MORRIS DH, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1[J]. N Engl J Med, 2020, 382(16): 1564-1567. DOI: 10.1056/NEJMc2004973.
    [19] 国家卫生健康委员会办公厅, 国家中医药管理局办公室. 关于印发新型冠状病毒肺炎诊疗方案(试行第九版)的通知[A/OL]. [2023-01-06]. http://www.gov.cn/zhengce/zhengceku/2022-03/15/content_5679257.htm.
    [20] AL BAYAT S, MUNDODAN J, HASNAIN S, et al. Can the cycle threshold (Ct) value of RT-PCR test for SARS CoV2 predict infectivity among close contacts?[J]. J Infect Public Health, 2021, 14(9): 1201-1205. DOI: 10.1016/j.jiph.2021.08.013.
    [21] MISHRA B, RANJAN J, PURUSHOTHAM P, et al. High proportion of low cycle threshold value as an early indicator of COVID-19 surge[J]. J Med Virol, 2022, 94(1): 240-245. DOI: 10.1002/jmv.27307.
    [22] 中华医学会器官移植学分会, 中国医师协会器官移植医师分会. 中国公民逝世后捐献供器官功能评估和维护专家共识(2016版)[J/CD]. 中华移植杂志(电子版), 2016, 10(4): 145-153. DOI: 10.3877/cma.j.issn.1674-3903.2016.04.001.

    Branch of Organ Transplantation of Chinese Medical Association, Chinese Society of Organ Transplantation, Branch of Organ Transplant Physician of Chinese Medical Doctor Association. Expert consensus on the assessment and maintenance of the function of donor organs donated after citizen's death in China (2016 edition)[J/CD]. Chin J Transplant (Electr Edit), 2016, 10(4): 145-153. DOI: 10.3877/cma.j.issn.1674-3903.2016.04.001.
    [23] SHAH M, WOO HG. Omicron: a heavily mutated SARS-CoV-2 variant exhibits stronger binding to ACE2 and potently escapes approved COVID-19 therapeutic antibodies[J]. Front Immunol, 2022, 12: 830527. DOI: 10.3389/fimmu.2021.830527.
    [24] BREVINI T, MAES M, WEBB GJ, et al. FXR inhibition may protect from SARS-CoV-2 infection by reducing ACE2[J]. Nature, 2022, DOI: 10.1038/s41586-022-05594-0[Epub ahead of print].
    [25] MEO SA, MEO AS, AL-JASSIR FF, et al. Omicron SARS-CoV-2 new variant: global prevalence and biological and clinical characteristics[J]. Eur Rev Med Pharmacol Sci, 2021, 25(24): 8012-8018. DOI: 10.26355/eurrev_202112_27652.
    [26] STEIN SR, RAMELLI SC, GRAZIOLI A, et al. SARS-CoV-2 infection and persistence in the human body and brain at autopsy[J]. Nature, 2022, 612(7941): 758-763. DOI: 10.1038/s41586-022-05542-y.
    [27] HASSANEIN M, RADHAKRISHNAN Y, SEDOR J, et al. COVID-19 and the kidney[J]. Cleve Clin J Med, 2020, 87(10): 619-631. DOI: 10.3949/ccjm.87a.20072.
    [28] BRAUN F, LÜTGEHETMANN M, PFEFFERLE S, et al. SARS-CoV-2 renal tropism associates with acute kidney injury[J]. Lancet, 2020, 396(10251): 597-598. DOI: 10.1016/S0140-6736(20)31759-1.
    [29] DIAO B, WANG C, WANG R, et al. Human kidney is a target for novel severe acute respiratory syndrome coronavirus 2 infection[J]. Nat Commun, 2021, 12(1): 2506. DOI: 10.1038/s41467-021-22781-1.
    [30] GOLMAI P, LARSEN CP, DEVITA MV, et al. Histopathologic and ultrastructural findings in postmortem kidney biopsy material in 12 patients with AKI and COVID-19[J]. J Am Soc Nephrol, 2020, 31(9): 1944-1947. DOI: 10.1681/ASN.2020050683.
    [31] SHARMA P, UPPAL NN, WANCHOO R, et al. COVID-19-associated kidney injury: a case series of kidney biopsy findings[J]. J Am Soc Nephrol, 2020, 31(9): 1948-1958. DOI: 10.1681/ASN.2020050699.
    [32] WANG L, LI X, CHEN H, et al. Coronavirus disease 19 infection does not result in acute kidney injury: an analysis of 116 hospitalized patients from Wuhan, China[J]. Am J Nephrol, 2020, 51(5): 343-348. DOI: 10.1159/000507471.
    [33] WANG W, XU Y, GAO R, et al. Detection of SARS-CoV-2 in different types of clinical specimens[J]. JAMA, 2020, 323(18): 1843-1844. DOI: 10.1001/jama.2020.3786.
    [34] 崔浩, 梁静, 向慧玲. 新型冠状病毒肺炎相关肝损伤研究进展[J]. 临床肝胆病杂志, 2022, 38(4): 931-935. DOI: 10.3969/j.issn.1001-5256.2022.04.039.

    CUI H, LIANG J, XIANG HL. Research advances in coronavirus disease 2019-related liver injury[J]. J Clin Hepatol, 2022, 38(4): 931-935. DOI: 10.3969/j.issn.1001-5256.2022.04.039.
    [35] GUAN WJ, NI ZY, HU Y, et al. Clinical characteristics of coronavirus disease 2019 in China[J]. N Engl J Med, 2020, 382(18): 1708-1720. DOI: 10.1056/NEJMoa2002032.
    [36] RICHARDSON S, HIRSCH JS, NARASIMHAN M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area[J]. JAMA, 2020, 323(20): 2052-2059. DOI: 10.1001/jama.2020.6775.
    [37] KATES OS, FISHER CE, RAKITA RM, et al. Emerging evidence to support not always "just saying no" to SARS-CoV-2 positive donors[J]. Am J Transplant, 2020, 20(11): 3261-3262. DOI: 10.1111/ajt.16119.
    [38] APASL Covid-19 Task Force, LAU G, SHARMA M. Clinical practice guidance for hepatology and liver transplant providers during the COVID-19 pandemic: APASL expert panel consensus recommendations[J]. Hepatol Int, 2020, 14(4): 415-428. DOI: 10.1007/s12072-020-10054-w.
    [39] WANG Y, LIU S, LIU H, et al. SARS-CoV-2 infection of the liver directly contributes to hepatic impairment in patients with COVID-19[J]. J Hepatol, 2020, 73(4): 807-816. DOI: 10.1016/j.jhep.2020.05.002.
    [40] BLOOM PP, MEYEROWITZ EA, REINUS Z, et al. Liver biochemistries in hospitalized patients with COVID-19[J]. Hepatology, 2021, 73(3): 890-900. DOI: 10.1002/hep.31326.
    [41] HENRY BM, DE OLIVEIRA MHS, BENOIT S, et al. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis[J]. Clin Chem Lab Med, 2020, 58(7): 1021-1028. DOI: 10.1515/cclm-2020-0369.
    [42] LIU PP, BLET A, SMYTH D, et al. The science underlying COVID-19: implications for the cardiovascular system[J]. Circulation, 2020, 142(1): 68-78. DOI: 10.1161/CIRCULATIONAHA.120.047549.
    [43] LINDNER D, FITZEK A, BRÄUNINGER H, et al Association of cardiac infection with SARS-CoV-2 in confirmed COVID-19 autopsy cases[J]. JAMA Cardiol, 2020, 5(11): 1281-1285. DOI: 10.1001/jamacardio.2020.3551.
    [44] TIAN S, XIONG Y, LIU H, et al. Pathological study of the 2019 novel coronavirus disease (COVID-19) through postmortem core biopsies[J]. Mod Pathol, 2020, 33(6): 1007-1014. DOI: 10.1038/s41379-020-0536-x.
    [45] WU C, HU X, SONG J, et al. Heart injury signs are associated with higher and earlier mortality in coronavirus[EB/OL]. [2023-01-06]. https://www.medrxiv.org/content/10.1101/2020.02.26.20028589v1.
    [46] XU Z, SHI L, WANG Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome[J]. Lancet Respir Med, 2020, 8(4): 420-422. DOI: 10.1016/S2213-2600(20)30076-X.
    [47] AMMIRATI E, LUPI L, PALAZZINI M, et al. Prevalence, characteristics, and outcomes of COVID-19-associated acute myocarditis[J]. Circulation, 2022, 145(15): 1123-1139. DOI: 10.1161/CIRCULATIONAHA.121.056817.
    [48] The Ad Hoc Disease Transmission Advisory Committee of Organ Procurement and Transplantation Network. Disease transmission advisory committee[EB/OL]. [2023-01-07]. https://optn.transplant.hrsa.gov/about/committees/disease-transmission-advisory-committee/.
    [49] KOVAL CE, ELTEMAMY M, POGGIO ED, et al. Comparative outcomes for over 100 deceased donor kidney transplants from SARS-CoV-2 positive donors: a single-center experience[J]. Am J Transplant, 2022, 22(12): 2903-2911. DOI: 10.1111/ajt.17203.
    [50] KOVAL CE, POGGIO ED, LIN YC, et al. Early success transplanting kidneys from donors with new SARS-CoV-2 RNA positivity: a report of 10 cases[J]. Am J Transplant, 2021, 21(11): 3743-3749. DOI: 10.1111/ajt.16765.
    [51] MOLNAR MZ, HALL IE, RAGHAVAN D, et al. Kidney transplantation from SARS-CoV-2-positive deceased donor[J]. Am J Transplant, 2022, 22(4): 1280-1282. DOI: 10.1111/ajt.16905.
    [52] PUODZIUKAITE L, SERPYTIS M, KUNDROTAITE A, et al. Kidney transplantation from a SARS-CoV-2-positive donor for the recipients with immunity after COVID-19[J]. Transpl Infect Dis, 2021, 23(4): e13666. DOI: 10.1111/tid.13666.
    [53] ROMAGNOLI R, GRUTTADAURIA S, TISONE G, et al Liver transplantation from active COVID-19 donors: a lifesaving opportunity worth grasping?[J]. Am J Transplant, 2021, 21(12): 3919-3925. DOI: 10.1111/ajt.16823.
    [54] JAYASEKERA CR, VIKRAM HR, RIFAT Z, et al. Solid organ transplantation from SARS-CoV-2-infected donors to uninfected recipients: a single-center experience[J]. Transplant Direct, 2022, 8(2): e1286. DOI: 10.1097/TXD.0000000000001286.
    [55] WALL AE, MCKENNA GJ, ONACA N, et al. Utilization of a SARS-CoV-2-positive donor for liver transplantation[J]. Proc (Bayl Univ Med Cent), 2021, 35(1): 62-63. DOI: 10.1080/08998280.2021.1985888.
    [56] GOSS MB, LEUNG DHB, POUCH SM, et al. A new chapter in an evolving pandemic: successful pediatric liver transplantation with SARS-CoV-2+ donors[J]. Pediatr Transplant, 2022, 26(8): e14407. DOI: 10.1111/petr.14407.
    [57] NGUYEN MC, LEE EJ, AVERY RK, et al. Transplant of SARS-CoV-2-infected living donor liver: case report[J]. Transplant Direct, 2021, 7(8): e721. DOI: 10.1097/TXD.0000000000001178.
    [58] EICHENBERGER EM, CONIGLIO AC, MILANO C, et al. Transplanting thoracic COVID-19 positive donors: an institutional protocol and report of the first 14 cases[J]. J Heart Lung Transplant, 2022, 41(10): 1376-1381. DOI: 10.1016/j.healun.2022.06.018.
  • 加载中
图(3)
计量
  • 文章访问数:  126
  • HTML全文浏览量:  5
  • PDF下载量:  11
  • 被引次数: 0
出版历程
  • 收稿日期:  2023-01-07
  • 网络出版日期:  2023-01-17
  • 刊出日期:  2023-01-15

目录

    /

    返回文章
    返回