Figure 711

Organ donor hepatitis C virus (HCV) transmission. Most recipients of a kidney from a donor positive for hepatitis C virus RNA will become infected with HCV if the organ is preserved in ice. ELISA-1 testing of serum samples from 711 cadaveric organ donors identified 13 donors positive for anti-HCV infection; 29 recipients of organs from these donors were followed [91,92]. The prevalence of HCV RNA in these allograft recipients increased from 27% before transplantation to 96% after transplantation. In contrast, studies from centers using pulsatile perfusion of the kidney during preservation have confirmed transmission of HCV in only about 56% of cases [93,94]. Several factors might explain the discrepancy in transmission rates. One possibility may involve differences in organ preservation. Zucker and colleagues [97] demonstrated that pulsatile perfusion removed 99% of the estimated viral burden in the kidney, and centers using pulsatile perfusion have consistently reported lower transmission rates than do centers preserving organs on ice. Additional factors could include geographic variation in HCV quasi-species and the magnitude of the circulating viral titer in the donor at the time of harvesting.

Reference

Posttransplantation HCV infection status

Anti-HCV, n/n (%)

HCV RNA, n/n (%)

Pereira et al. [91,92]

16/24(67)

23/24(96)

Roth et al. [93]

10/31(32)

Not available

Tesi et al. [94]

15/43(35)

21/37(57)

Vincente et al. [95]

1/7(14)

1/7(14)

Wreghtt et al [96]

6/15(40)

12/14(86)

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