title: False positive hepatitis C antibody test results in left ventricular assist device recipients: increased risk with age and transfusions.
abstract: Left ventricular assist devices (LVADs) have been successfully used in patients with heart failure. However, LVADs may trigger immune activation, leading to higher frequencies of autoantibodies. We describe the clinical, epidemiological, and laboratory characteristics of LVAD recipients with false positive hepatitis C (FPHC) serology among 39 consecutive adult LVAD recipients who bridged to heart transplantation from January 2007 to January 2013 at Montefiore Medical Center. FPHC patients were identified as those with post-LVAD positive hepatitis C ELISA antibody tests and negative confirmatory testing with hepatitis C RNA PCR and/or radioimmunoblot assay. Ten (26%) patients previously seronegative for hepatitis C were found to have FPHC after device placement. Of the 39 patients, 32 had HeartMate II devices. The mean age at LVAD placement was 55 years. FPHC correlated with older age at the time of LVAD implantation and with receipt of packed red blood cell transfusions, but not with gender, fresh frozen plasma transfusions, panel reactive antibodies, globulin fraction, rheumatoid factor, or anticardiolipin antibodies. Clinicians should be aware of this increased risk of FPHC in older LVAD patients and those more heavily transfused in order to avoid unnecessary apprehension and possible delay in transplantation. Further studies should be done to evaluate the possible relationship between transfused blood products and immunomodulation.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Grace Y
authors.initials: GY
authors.lastname: Minamoto
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Doreen
authors.initials: D
authors.lastname: Lee
authors.affiliation: Department of Surgery, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Adriana
authors.initials: A
authors.lastname: Colovai
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Dana
authors.initials: D
authors.lastname: Levy
authors.affiliation: Department of Pathology, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Vasovic
authors.affiliation: Department of Medicine, Weill Medical College of Cornell University, New York, NY, USA.
authors.forename: Keith W
authors.initials: KW
authors.lastname: Roach
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shuter
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Goldstein
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: David
authors.initials: D
authors.lastname: D'Alessandro
authors.affiliation: Division of Cardiology, Department of Medicine, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Ulrich P
authors.initials: UP
authors.lastname: Jorde
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, NY, USA.
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Muggia
keywords: Hepatitis C; allosensitization; left ventricular assist device (LVAD)