02542nas a2200265   4500008003900000245012100039210006900160260000800229490000800237520177500245100001402020700002202034700002102056700002202077700001202099700001402111700001402125700001402139700001602153700001702169700001402186700001602200700001102216856004902227       2018                          d00aTransmission of Hepatitis E Virus With Plasma Exchange in Kidney Transplant Recipients: A Retrospective Cohort Study0 aTransmission of Hepatitis E Virus With Plasma Exchange in Kidney  cAug0 v1023 aBACKGROUND:  After observing a case of plasma exchange-mediated hepatitis E virus (HEV) infection in a kidney transplant recipient, we investigated the relationship between plasma exchange and HEV infection after kidney transplantation. METHODS:  A cohort of 263 patients who underwent kidney transplantation from January 1, 2011, through December 31, 2012, was screened for HEV markers, including anti-HEV IgG and IgM antibodies and HEV ribonucleic acid (RNA), on 3 consecutive blood samples: 1 before, 1 with a mean (standard deviation) of 9.5 (9) months, and 1 with a mean (standard deviation) of 18.2 (6.6) months after transplantation, respectively. Transfusional investigation was performed in patients with detectable HEV RNA. We explored the relationships between plasma exchange, posttransplantation transaminase elevation and HEV markers acquisition. RESULTS:  Overall, 24 (9.1%) patients had acquired HEV markers on the first posttransplantation sample, including 2 patients with detectable HEV RNA, and 7 (2.3%) patients had long-term persistent HEV markers on the second posttransplantation sample, including 3 patients with detectable HEV RNA without detectable anti-HEV antibodies. Plasma exchange was an independent risk factor for the acquisition of posttransplantation and long-term persistent HEV markers. Pathogen-reduced plasma-borne transmission of HEV was demonstrated. Plasma exchange and long-term persistent HEV markers were risk factors of posttransplantation transaminase elevation. CONCLUSIONS:  Plasma exchange, including with pathogen-reduced plasma, is a risk factor for posttransplantation HEV infection and transaminase elevation. Screening for HEV RNA should be carried out in kidney transplant recipients treated with plasma exchange.1 aMallet, V1 aSberro-Soussan, R1 aRoque-Afonso, AM1 aVallet-Pichard, A1 aDeau, B1 aPortal, A1 aChaix, ML1 aHauser, L1 aBeyloune, A1 aMercadier, A1 aIzopet, J1 aLegendre, C1 aPol, S  uhttps://www.notifylibrary.org/reference/4805