Multicenter Prospective Study for Laboratory Diagnosis of HHV8 Infection in Solid Organ Donors and Transplant Recipients and Evaluation of the Clinical Impact After Transplantation

Abstract

Serological assays, specifically lytic IFAs, were the best methodological approach to identify HHV8-infected SOT donors and recipients. A very low incidence (1.9%) of posttransplant HHV8-related disease was observed.

Successful treatment of primary donor‐derived human herpesvirus‐8 infection and hepatic Kaposi Sarcoma in an adult liver transplant recipient

“…The prevalence of post‐transplant KS largely mirrors regional seroprevalence patterns, ranging from 0.1% to 1% in non‐endemic regions, such as the United States, and up to 5% to 30% in regions with higher HHV‐8 seroprevalence . Following transplantation, KS may develop as a result of viral reactivation in seropositive patients or, much less frequently, from primary infection or transmission of donor‐derived tumor progenitors in recipients who received grafts from an HHV‐8‐positive donor . In such cases, the involvement of the transplanted organ is rare .…”

“…Neither the risk of primary HHV‐8 infection among from a seropositive donor to a seronegative recipient nor the risk of developing KS following primary HHV‐8 infection have been fully established in the context of solid organ transplantation due to variability in diagnostic tools used to define HHV‐8 seropositivity and small sample populations. Early studies suggest a relatively high rate of seroconversion in patients receiving grafts from seropositive donors, ranging from 25% to 50% . Prospective studies evaluating the feasibility and clinical benefit of post‐transplantation screening and prevention strategies, and the development of gold standard diagnostic tests are warranted …”

“…12 Following transplantation, KS may develop as a result of viral reactivation in seropositive patients or, much less frequently, from primary infection or transmission of donor-derived tumor progenitors in recipients who received grafts from an HHV-8-positive donor. 4,5,13,14 In such cases, the involvement of the transplanted organ is rare. 15 The development of KS in the patients described in this report, however, likely resulted as a consequence of primary donor-derived HHV-8 infection or possible tumor progenitor transmission from the donor to both split liver recipients, as the origin of the malignant cells was not confirmed.…”

“…Early studies suggest a relatively high rate of seroconversion in patients receiving grafts from seropositive donors, ranging from 25% to 50%. 13,19 Prospective studies evaluating the feasibility and clinical benefit of post-transplantation screening and prevention strategies, and the development of gold standard diagnostic tests are warranted. 13 Indications for treatment of KS include symptomatic disease, extensive or progressive cutaneous disease, and visceral involvement.…”

Liver Disease Associated with Non-Hepatitis Viruses

“…The diagnosis of HHV-8 associated malignancies is established from biopsies via their characteristic histopathological features. The virus itself is detected by various antibody assays or polymerase chain reaction (PCR) assays (Chiereghin et al, 2017).…”