Hepatitis C status of heart transplant recipients

Department of Gastroenterology, University of Padua, Italy.
Clinical Transplantation (Impact Factor: 1.52). 03/1998; 12(1):5-10.
Source: PubMed


The records of 155 consecutive patients who underwent successful heart transplantation (HTx) were reviewed to document the incidence of hepatitis C (HCV) infection. One patient was HCV RNA positive pre-HTx, and 12 patients (8%) developed transient or permanent HCV positivity post-HTx. HCV RNA positivity was associated with biochemical features of liver injury. Liver biopsy was performed in 8, and demonstrated features of chronic hepatitis in all. Two patients died of chronic liver failure at 50 and 56 months post-HTx, respectively. Interferon therapy was given to three patients, two of whom converted to HCV negativity. This study suggests that HCV infection is more common than previously anticipated in HTx patients, and varies from a mild transient condition to a fatal chronic liver failure.

1 Read
  • [Show abstract] [Hide abstract]
    ABSTRACT: Heart transplant (HTx) recipients risk acquiring hepatotropic viral infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV), and the impact of these infections on post-HTx survival remains unclear. The aim of the present study was to define the prevalence, clinical features, and natural history of HBV and HCV infections in a cohort of HTx recipients. We retrospectively studied 360 consecutive patients who had undergone HTx. Clinical picture, hepatic injury indexes, and HBV/HCV viral serology were followed post-transplant. During follow-up (average, 8 +/- 3.1 years), 49 (16.5%) of the HTx recipients tested positive for at least 1 of the 2 viruses (3.1% HBV, 12% HCV, 0.5% concomitant infection). The prevalence of HCV infection in heart transplant recipients transplanted before and after 1990 was 28% and 4.2%, respectively, the latter being markedly lower (p < 0.001) than in earlier series of HTx recipients and much lower than expected in the age- and sex-matched general population. All HBV-positive and 58% of HCV-positive recipients developed chronic liver disease. Sixteen percent of patients developed cirrhosis during follow-up, and 8% died of end-stage liver disease. The prevalence of HBV and HCV in a large population of HTx recipients is not very different from that reported in the general population. Active viral replication of HBV and an aggressive natural history of both infections are seen in HTx recipients, however. The low prevalence of HBV- and HCV-related infection in recent series probably reflects current viral screening and vaccination policies.
    The Journal of Heart and Lung Transplantation 08/2001; 20(7):718-24. DOI:10.1016/S1053-2498(01)00255-8 · 6.65 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Hepatitis C virus (HCV) infection is a worldwide epidemic that is causing substantial morbidity and mortality in the general population. Due to inherent risks of HCV transmission through blood and tissue, solid organ and bone marrow transplant recipients have a higher incidence of HCV infection than that of the general population, especially in those transplanted prior to widespread screening for HCV in the early 1990s. The impact of HCV infection in liver transplantation is well characterized, but is less frequently discussed in kidney, heart, lung, and bone marrow transplantation. This article provides a comprehensive and current review of the literature with regard to the epidemiology, pathogenesis, outcome, and treatment of HCV infection in the setting of kidney, heart, lung, and bone marrow transplantation.
    Current Hepatitis Reports 12/2003; 2(4):159-165. DOI:10.1007/s11901-003-0018-x
  • [Show abstract] [Hide abstract]
    ABSTRACT: Hepatitis C virus (HCV) is common in certain solid organ transplant recipients, most notably in those undergoing liver or kidney transplantation. Infection typically antedates transplantation but may have been acquired at the time of transplantation via infected blood products or organs. A more rapid and aggressive course of HCV-related infection and liver disease is the major concern in organ transplant recipients compared with immunocompetent patients. HCV-related liver disease is an important cause of morbidity and mortality in patients with end-stage renal disease treated by dialysis or transplantation. The outcome of HCV infection in renal and liver transplant recipients has been extensively investigated, whereas literature on HCV-related liver disease among patients with orthotopic heart transplantation is scanty. This article reviews the literature concerning the treatment of HCV-related liver disease in renal and orthotopic heart transplantation.
    Clinics in Liver Disease 09/2005; 9(3):487-503, viii. DOI:10.1016/j.cld.2005.05.006 · 3.66 Impact Factor
Show more