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, Jorge Rakela

Research output: Contribution to journalArticle

22 Citations (Scopus)

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 - 1995

Fingerprint

Hepatitis C
Hepacivirus
Infection
Virus Diseases
Hepatitis C Antibodies
Transplantation
RNA
Heart Transplantation
Transplant Recipients
Tissue Donors
Liver Diseases
Liver Failure
Reverse Transcriptase Polymerase Chain Reaction
Serum
Immunoglobulins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Transplantation

Cite this

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.

Prevalence and outcome of hepatitis C infection among heart transplant recipients. / Zein, N. N.; McGreger, C. G A; Wendt, N. K.; Schwab, K.; Mitchell, P. S.; Persing, D. H.; Rakela, Jorge.

In: Journal of Heart and Lung Transplantation, Vol. 14, No. 5, 1995, p. 865-869.

Research output: Contribution to journalArticle

Zein, NN, McGreger, CGA, Wendt, NK, Schwab, K, Mitchell, PS, Persing, DH & Rakela, J 1995, 'Prevalence and outcome of hepatitis C infection among heart transplant recipients', Journal of Heart and Lung Transplantation, vol. 14, no. 5, pp. 865-869.
Zein NN, McGreger CGA, Wendt NK, Schwab K, Mitchell PS, Persing DH et al. Prevalence and outcome of hepatitis C infection among heart transplant recipients. Journal of Heart and Lung Transplantation. 1995;14(5):865-869.
Zein, N. N. ; McGreger, C. G A ; Wendt, N. K. ; Schwab, K. ; Mitchell, P. S. ; Persing, D. H. ; Rakela, Jorge. / Prevalence and outcome of hepatitis C infection among heart transplant recipients. In: Journal of Heart and Lung Transplantation. 1995 ; Vol. 14, No. 5. pp. 865-869.
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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.",
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N2 - 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.

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