Prevalence and outcome of hepatitis C infection among heart transplant recipients

N. N. Zein, C. G.A. McGreger, N. K. Wendt, K. Schwab, P. S. Mitchell, D. H. Persing, J. Rakela

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Background: Hepatitis C virus infection is common in organ transplant recipients, and can be associated with significant morbidity and mortality. A unique feature of this infection among immunosuppressed patients is that it can progress without the development of hepatitis C virus antibodies. Methods: To define the prevalence of hepatitis C virus infection in patients undergoing heart transplantation and identify clinical syndromes associated with hepatitis C virus infection in heart transplant recipients, we collected sera from 59 consecutive heart transplant recipients and their donors. Samples were tested before and after transplantation for hepatitis C virus antibodies with the use of a second-generation recombinant immunoblot assay and for hepatitis C virus RNA by means of reverse transcriptase polymerase chain reaction. Results: Four of 59 patients (7%) had hepatitis C virus-RNA detected in posttransplantation serum samples; but only one of these was anti-hepatitis C virus antibody positive. Two of the four patients with hepatitis C virus RNA detected after transplantation received organs from donors who were positive for hepatitis C virus RNA/anti-hepatitis C virus. One of these two recipients tested positive for hepatitis C virus antibody and hepatitis C virus RNA before transplantation. The other two patients received organs from hepatitis C virus negative donors and possibly acquired infection after transplantation from blood or immunoglobulin preparations. One patient was anti-hepatitis C virus positive before transplantation but had no detectable hepatitis C virus RNA, and hepatitis C virus infection did not develop after transplantation. Progressive hepatitis C virus-induced cholestatic liver disease that led to hepatic failure and death after heart transplantation occurred in one of the four patients. Conclusion: Hepatitis C virus infection may occur after heart transplantation in the absence of antihepatitis C virus antibodies, and a syndrome of severe cholestatic liver disease may complicate heart transplantation in the presence of hepatitis C virus infection.

Original languageEnglish (US)
Pages (from-to)865-869
Number of pages5
JournalJournal of Heart and Lung Transplantation
Volume14
Issue number5
StatePublished - Jan 1 1995

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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    Zein, N. N., McGreger, C. G. A., Wendt, N. K., Schwab, K., Mitchell, P. S., Persing, D. H., & Rakela, J. (1995). Prevalence and outcome of hepatitis C infection among heart transplant recipients. Journal of Heart and Lung Transplantation, 14(5), 865-869.