Kidney Transplants With Positive Anti-Hepatitis C Virus Donors

Otero, Joaquín R.; García, Manuel Rodríguez; Escudero, Domingo; Gómez, E.; Aguado, S; Oña, Marı́a de

doi:10.1097/00007890-199012000-00052

Cited by 20 publications

(8 citation statements)

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“…Furthermore these data emphasise that the best practical protocol to prevent transfer of HCV by organ transplantation is to determine the antibody status of potential donors and to exclude from transplantation all that are positive. The data presented here extend previously published work [Otero et al, 1990;Shuch et al, 1992;Poterucha et al, 1992, etc. ] by giving a more accurate time course of the infection and of the temporal relations of viraemia and antibody response.…”

Section: Discussionsupporting

confidence: 92%

Hepatitis C virus infections in transplant patients: Serological and virological investigations

Maple

Mckee

Desselberger

et al. 1994

Journal of Medical Virology

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Hepatitis C virus (HCV) is transmitted by organs of HCV antibody-positive donors to transplant recipients. This study investigated the serological and virological responses of 14 initially HCV antibody-negative transplant patients who received organs from four HCV antibody-positive donors (A-D) (before donor screening for HCV infection was introduced in 1991). Second generation HCV enzyme immunoassay (Abbott HCV EIA) was used to detect anti-HCV antibody. Recombinant immunoblot (RIBA-2; Chiron Corporation) and Wellcozyme Western blot (Wwb) assays were compared as confirmatory assays of positive EIA results. Reverse transcription (RT) followed by "nested" polymerase chain reaction (PCR) was performed to detect viral RNA. HCV RNA was only found in the sera of donors B and C, however, transplantation of organs from all donors resulted in infection of all recipients. HCV RNA was found in recipient sera within 30 days after transplant and remained detectable throughout the period of sampling. An anti-HCV antibody response was found in only 6 (of the 14) recipients and only after 300 days. Much longer periods passed before detection of HCV antibody in six recipients. For detection of HCV infection in transplant recipients it is essential that testing for HCV RNA by RT-PCR is carried out.

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Section: Discussionsupporting

confidence: 92%

Hepatitis C virus infections in transplant patients: Serological and virological investigations

Maple

Mckee

Desselberger

et al. 1994

Journal of Medical Virology

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“…Otero et al [3] showed in 45 donors a 4% positivity, and 1 of the 3 negative recipients became positive 7 months after trans plantation. Ponz et al [4] did not mention the status of the donors and found a 14% positivity in recipients who were previously negative, recording that these patients had re ceived more transfusions than the others.…”

Section: Discussionmentioning

confidence: 95%

Antibodies to Hepatitis C Virus in Kidney Transplantation

Triolo¹,

Squiccimarro

Baldi

et al. 1992

Nephron

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Ninety patients on dialysis, 241 cadaveric kidney donors and 27 cadaveric kidney recipients with a follow-up of 2 years, have been investigated as for anti-HCV positivity by means of 3 tests. As for patients on dialysis and cadaveric donors, the prevalence was 32 and 4%, respectively. As for transplanted patients, it must be noted that 4 negative recipients from positive donors seroconverted, but without any change in hepatic enzymes, while in 2 or 9 anti-HCV-positive recipients, hepatic enzymes increased after transplantation. Seroconversion in patients transplanted from a negative donor was not significantly different. We conclude that, according to their experience, anti-HCV positivity in the donors is not associated with a significant risk of infection in recipients of cadaveric grafts.

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“…The patients who became positive could have been infected by transfusion during surgery or by the graft, as viral infection can be transmit ted by donor to recipient [21,36,37], As some patients with HCV infection developed chronic liver disease, the possibility of transmission of hepatitis C by the graft might be considered and the acceptability of the anti-HCV-positive donor questioned [36,38]. Other authors suggest that HCV-positive organs can be transplanted in recipients with special characteristics and antibodies to HCV detected by RIBA [38].…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C Antibody after Kidney Transplantation: Clinical Significance

Marcén

Gámez²,

Mateos³

et al. 1993

Am J Nephrol

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The prevalence of antibodies to hepatitis C virus (HCV) was investigated in 231 renal transplantation recipients, by a first- and second-generation EI A assay and a second-generation immunoblot assay (4-RIBA). Before transplantation, prevalence of anti-HCV was 22.6% and was related to the time on dialysis (p < 0.01), transfusions (p < 0.01) and previous history of chronic liver disease (p < 0.01. Following transplantation, 32 patients (13.9%) were anti-HCV positive by the first-generation enzyme immunoassay (EIA) and it increased to 57 patients (24.7%) when anti-HCV was measured by the second-generation EIA. The 4-RIBA assay confirmed the positivity in 46 patients (80.7%), 11 patients (19.3%) were indeterminate. Seroconversion after grafting was observed in 7 negative patients, and another 7 patients became negative after the procedure. The presence of anti-HCV antibody after transplantation was determined by the patient status on dialysis, 80% of them being positive before surgery. Twenty-one 4-RIBA-positive transplantation patients (45.7%) had persistently or intermittently abnormalities on liver function tests, suggesting chronic liver disease. A liver biopsy performed on 10 of these patients showed; chronic active hepatitis in 6, chronic persistent hepatitis in 2, and chronic lobular hepatitis in the other 2 patients. Another 23 4-RIBA-positive transplantation patients had normal alanine aminotransferase levels despite long follow-up (66.2 ± 32.2 months). The prevalence of anti-HCV antibody can be underestimated if the antibody is measured by first-generation EIA alone. About 50% ofpatients with anti-HCV had chronic liver disease, and the histological findings suggested a possible evolution to cirrhosis. The significance of the coexistence of anti-HCV and normal function test needs further evaluation.

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Kidney Transplants With Positive Anti-Hepatitis C Virus Donors

Cited by 20 publications

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Hepatitis C virus infections in transplant patients: Serological and virological investigations

Hepatitis C virus infections in transplant patients: Serological and virological investigations

Antibodies to Hepatitis C Virus in Kidney Transplantation

Hepatitis C Antibody after Kidney Transplantation: Clinical Significance

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