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 24 May 2018

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News

Donor screening should include test for Hep C virus RNA

The latest Annals of Internal Medicine reports transmission of Hep C to several organ and tissue recipients from an antibody-negative donor, and suggests donor screening should include routine testing for Hep C virus RNA.

News image

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Although Hepatitis C virus 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.

Dr Barna Tugwell and colleagues conducted a descriptive epidemiologic study and serum testing for Hepatitis C infection.

The investigators determined whether the donor was the source of infection and the extent of transmission to other organ and tissue recipients.

The team recovered 91 tissues or organs from the donor, and assessed the donor and graft recipients located in 16 states and 2 other countries.

Hepatitis C virus infection was defined as the presence of anti-Hepatitis C virus or Hepatitis C virus RNA.

No cases of transmission occurred in recipients of skin or the cornea
Annals of Internal Medicine

The investigative team determined the genetic relatedness of viral isolates from the donor and recipients by genotype comparison and quasi-species analysis.

The team reported that the donor was anti-Hepatitis C virus-negative but was Hepatitis C virus RNA-positive having genotype 1a.

The team noted that 40 persons received transplants during 22 months.

The investigators identified 5 persons who were Hepatitis C-infected before transplantation or had a genotype other than 1a.

A further 5 persons had no post-transplantation serum specimens available.

Of the remaining 30 recipients, the team observed that Hepatitis C infection occurred in 8 recipients.

The infection occurred in 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.

In addition, the investigators observed no cases occurring in 2 recipients of skin, 1 recipient of the cornea, or in 16 receiving irradiated bone.

The team reported that a limitation of the study was that post-transplantation serum specimens were unavailable for 5 recipients.

Dr Tugwell's team commented, “An anti-Hepatitis C-negative donor was the source of Hepatitis C infection for 8 recipients of organs or tissues.”

“Although Hepatitis C transmission from anti-Hepatitis C-negative donors is probably uncommon, changes in donor screening to include routine testing for Hepatitis C virus RNA merit further consideration to improve the safety of transplantation.”

Ann Int Med 2005: 143(9): 648-54
04 November 2005

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