Transmission of hepatitis C virus by organ transplantation

Article Abstract:

Between 7 percent and 24 percent of the patients who undergo kidney transplantation develop liver disease; in most cases, the cause of the disease is not identified. To determine whether infection with hepatitis C virus (HCV) could be the cause of liver disease following transplantation, tests were carried out on blood samples taken from all 716 organ donors to the New England Organ Bank during the past five years, and on the 29 recipients of their organs. The blood samples were analyzed for the presence of antibodies against HCV (anti-HCV) and hepatitis B. In addition, clinical information concerning the donors' health was reviewed. Results showed that 13 of the donors (1.8 percent) tested positive for anti-HCV; organs from 12 of these donors were actually used. No donor had clinical signs of hepatitis. Twenty-nine organs (19 kidneys, 6 hearts, 4 livers) were transplanted into recipients. Seven of 26 recipients, for whom blood tests were performed prior to transplantation, tested positive for anti-HCV. After transplantation, non-A, non-B hepatitis developed in 14 organ recipients (48 percent). The disease developed with the same prevalence in all recipients, regardless of the organ they had received, beginning, on average, 3.8 months after transplantation. Two patients died as a result of liver failure and the other 12 developed chronic liver disease. Analyses of the blood samples for 13 patients indicated that HCV caused the liver disease in 12 cases. Anti-HCV antibodies were more prevalent in this population of organ donors than in healthy blood donors in the US, where they are found in 0.6 percent of the samples. This may mean that these organ donors were more likely to have been involved in behavior associated with viral infections, such as intravenous drug use or promiscuity. A discussion is presented concerning the serious question of whether organs should be used from prospective donors who test positive for anti-HCV. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Diseases, Organ donors, Tissue donors

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Prevalence of hepatitis C virus RNA in organ donors positive for hepatitis C antibody and in the recipients of their organs

Article Abstract:

Patients who receive transplanted organs from donors who are infected with the hepatitis C virus (HCV) are likely to develop liver disease. Research indicates that organ transplantation can transmit infectious diseases such as hepatitis. A study of organ recipients shows that transmission approaches 100% when donors are infected. Using a polymerase chain reaction test to detect the HCV RNA that indicates an active infection, it was discovered that all 13 recipients of organs from infected donors tested positive for HCV RNA after transplantation, although all tested negative before their transplants. A group of 11 donors was tested for HCV RNA after they had donated organs. Nine of the 11 tested positive. Eventually 23 of 24 recipients of organs from these donors tested positive for HCV. This is a 96% rate, compared to the 27% rate of a group of recipients tested before transplantation. When both donors and recipients tested negative for HCV RNA before the transplantation, no cases of hepatitis infection were detected after the transplants.

Complications and side effects, Donation of organs, tissues, etc., Tissue donation

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Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant

Article Abstract:

Kidney transplants appear to substantially improve survival rates in people with end-stage kidney disease. Researchers compared mortality rates among 228,552 dialysis patients, some of whom were on a waiting list for a transplant or who had received a kidney transplant. Those on the waiting list had much lower mortality rates than those who were not. This indicates that healthier patients are placed on the waiting list. However, compared to those still on the waiting list, those who got a kidney transplant still had much lower mortality rates in the long-term.

Patient outcomes, Mortality, Organ transplant recipients, Kidneys, Kidney transplantation, Hemodialysis patients

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