title: Transmission of Hepatitis C Virus From Organ Donors Despite Nucleic Acid Test Screening.
abstract: Nucleic acid testing (NAT) for hepatitis C virus (HCV) is recommended for screening of organ donors, yet not all donor infections may be detected. We describe three US clusters of HCV transmission from donors at increased risk for HCV infection. Donor's and recipients' medical records were reviewed. Newly infected recipients were interviewed. Donor-derived HCV infection was considered when infection was newly detected after transplantation in recipients of organs from increased risk donors. Stored donor sera and tissue samples were tested for HCV RNA with high-sensitivity quantitative PCR. Posttransplant and pretransplant recipient sera were tested for HCV RNA. Quasispecies analysis of hypervariable region-1 was used to establish genetic relatedness of recipient HCV variants. Each donor had evidence of injection drug use preceding death. Of 12 recipients, 8 were HCV-infected-6 were newly diagnosed posttransplant. HCV RNA was retrospectively detected in stored samples from donor immunologic tissue collected at organ procurement. Phylogenetic analysis showed two clusters of closely related HCV variants from recipients. These investigations identified the first known HCV transmissions from increased risk organ donors with negative NAT screening, indicating very recent donor infection. Recipient informed consent and posttransplant screening for blood-borne pathogens are essential when considering increased risk donors.
authors.affiliation: Division of Viral Hepatitis, US Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: A
authors.initials: A
authors.lastname: Suryaprasad
authors.affiliation: Division of Healthcare Quality and Promotion, Office of Blood, Organ and Other Tissue Safety, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: S V
authors.initials: SV
authors.lastname: Basavaraju
authors.affiliation: Division of Healthcare Quality and Promotion, Office of Blood, Organ and Other Tissue Safety, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: S N
authors.initials: SN
authors.lastname: Hocevar
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, The Ohio State University, Columbus, OH.
authors.forename: N
authors.initials: N
authors.lastname: Theodoropoulos
authors.affiliation: Section of Infectious Disease and International Health, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
authors.forename: R A
authors.initials: RA
authors.lastname: Zuckerman
authors.affiliation: Division of Viral Hepatitis, US Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: T
authors.initials: T
authors.lastname: Hayden
authors.affiliation: Division of Viral Hepatitis, US Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: J C
authors.initials: JC
authors.lastname: Forbi
authors.affiliation: Perelman School of Medicine at the University of Pennsylvania Health System, Philadelphia, PA.
authors.forename: D
authors.initials: D
authors.lastname: Pegues
authors.affiliation: Perelman School of Medicine at the University of Pennsylvania Health System, Philadelphia, PA.
authors.forename: M
authors.initials: M
authors.lastname: Levine
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, The Ohio State University, Columbus, OH.
authors.forename: S I
authors.initials: SI
authors.lastname: Martin
authors.affiliation: Division of Healthcare Quality and Promotion, Office of Blood, Organ and Other Tissue Safety, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Kuehnert
authors.affiliation: Perelman School of Medicine at the University of Pennsylvania Health System, Philadelphia, PA.
authors.forename: E A
authors.initials: EA
authors.lastname: Blumberg
mesh_terms: D000328:Adult; D005260:Female; D006085:Graft Survival; D016174:Hepacivirus / Q000235:genetics* / Q000302:isolation & purification; D006526:Hepatitis C / Q000175:diagnosis* / Q000635:transmission* / Q000821:virology; D006801:Humans; D008297:Male; D016377:Organ Transplantation; D011379:Prognosis; D012367:RNA, Viral / Q000302:isolation & purification*; D012307:Risk Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000592:standards*; D019562:Viral Load
chemical_list: D012367:RNA, Viral
keywords: Clinical research; donor-derived infections; donors and donation; hepatitis C; infection and infectious agents; infectious disease; practice; viral