Outcome of de novo hepatitis C virus infection in heart transplant recipients.
The outcome of de novo hepatitis C virus (HCV) infection in heart transplant recipients of HCV-antibody positive organs is not known. The aim of the study was to determine the short-term outcome of de novo HCV infection in recipients of HCV-positive donor organs. HCV-antibody negative recipients of HCV-antibody positive hearts were identified from January 1, 1991 to February 28, 1998. Control patients matched for year of transplantation were also identified. Twenty-eight patients (22 males, mean age of 56 +/- 11 SD) received hearts from HCV-antibody-positive donors. The control group was similar to the patients in all clinical and demographic aspects. Twenty-three patients had detectable viremia by reverse-transcription polymerase chain reaction (RT-PCR). Of these 23 patients with de novo HCV infection, 7 (30%) developed HCV-related liver disease. Three patients (13%) had chronic hepatitis and 4 patients (17%) developed severe acute cholestatic hepatitis (ACH). Mycophenolate mofetil (MMF) use (P =.04) and high viral load at onset of acute liver disease (P =.02) were associated with ACH. Overall survival was similar between patients with de novo HCV infection and controls (P =.20). Development of ACH (P =.02) and MMF use (P =.0009) were associated with decreased survival in patients with de novo HCV infection. The present study showed that survival of patients with de novo HCV infection was similar to a matched control group. HCV-related severe ACH is associated with a poor short-term outcome in patients with de novo HCV infection. MMF use may be associated with a higher incidence of HCV-related severe ACH and a poor short-term outcome.
Ong
J P
JP
Department of Gastroenterology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Barnes
D S
DS
Younossi
Z M
ZM
Gramlich
T
T
Yen-Lieberman
B
B
Goormastic
M
M
Sheffield
C
C
Hoercher
K
K
Starling
R
R
Young
J
J
Smedira
N
N
McCarthy
P
P
D000206:Actuarial Analysis; D019992:Databases as Topic; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016027:Heart Transplantation / Q000401:mortality / Q000502:physiology*; D006526:Hepatitis C / Q000401:mortality / Q000473:pathology / Q000635:transmission*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D008107:Liver Diseases / Q000401:mortality / Q000473:pathology / Q000821:virology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000821:virology*; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors
D018937:Hepatitis C Antibodies