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Ann Intern Med. 2005 Nov 1;143(9):648-54.

Transmission of hepatitis C virus to several organ and tissue recipients from an antibody-negative donor.

Author information

  • 1Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. barna.tugwell@cdha.nshealth.ca

Abstract

BACKGROUND:

Although hepatitis C virus (HCV) transmission through tissue transplantation has been rarely reported, a donor with undetected viremia may infect several recipients. A patient developed acute hepatitis C shortly after tissue transplantation. Ninety-one tissues or organs had been recovered from the donor.

OBJECTIVE:

To determine whether the donor was the source of infection and the extent of transmission to other organ and tissue recipients.

DESIGN:

Descriptive epidemiologic study; serum testing for HCV infection.

SETTING:

Recipients were located in 16 states and 2 other countries.

PARTICIPANTS:

Donor and graft recipients.

MEASUREMENTS:

Hepatitis C virus infection was defined as the presence of anti-HCV or HCV RNA. The authors determined the genetic relatedness of viral isolates from the donor and recipients by genotype comparison and quasi-species analysis.

RESULTS:

The donor was anti-HCV-negative but was HCV RNA-positive (genotype 1a). Forty persons received transplants during 22 months. Five persons were HCV-infected before transplantation or had a genotype other than 1a, and 5 persons had no post-transplantation serum specimens available. Of the remaining 30 recipients, HCV infection occurred in 8 recipients: 3 of 3 organ recipients, 1 of 2 saphenous vein recipients, 1 of 3 tendon recipients, and 3 of 3 tendon with bone recipients. These 8 recipients had viral isolates genetically related to those of the donor. No cases occurred in recipients of skin (n = 2), cornea (n = 1), or irradiated bone (n = 16).

LIMITATIONS:

Post-transplantation serum specimens were unavailable for 5 recipients.

CONCLUSIONS:

An anti-HCV-negative donor was the source of HCV infection for 8 recipients of organs or tissues. Although HCV transmission from anti-HCV-negative donors is probably uncommon, changes in donor screening to include routine testing for HCV RNA merit further consideration to improve the safety of transplantation.

PMID:
16263887
[PubMed - indexed for MEDLINE]
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