02639nas a2200205   4500008004100000020001400041024001700055245010700072210006900179260031200248300001600560490000700576520169800583100002002281700001902301700001902320700002402339700002102363856004902384       2003                        eng d  a0041-1337  awej, 013214400aAllograft transmission of hepatitis C virus infection from infected donors in cardiac transplantation.0 aAllograft transmission of hepatitis C virus infection from infec  a(C) 2003 Lippincott Williams & Wilkins, Inc.b(1) Department of Internal Medicine, Ochsner Clinic Foundation, New Orleans, LA.(2) Cardiomyopathy and Heart Transplantation Center, Ochsner Clinic Foundation, New Orleans, LA.(3) Section of Gastroenterology and Hepatology, Ochsner Clinic Foundation, New c2003  a1096 - 11000 v763 aBackground.  The frequency and outcome of hepatitis C virus (HCV) infection in recipients of hearts from HCV-infected donors remains poorly characterized., Methods.  Between 1991 and 1999, 10 anti-HCV-negative patients received hearts from donors who were anti-HCV and HCV RNA-positive. Each recipient was tested for anti-HCV and HCV RNA and serially evaluated for liver dysfunction. Recipient records were reviewed for cumulative steroid boluses in the first posttransplant year and other components of the immune suppression regimen. We analyzed recipient outcome in relation to the virologic status of the donor, including the level of HCV RNA and genotype and the type of antirejection therapy., Results.  All 10 recipients became HCV RNA positive. Donor-recipient pairs expressed identical genotypes in each instance. Six of nine evaluable recipients developed biochemical evidence of hepatitis. Recipients with genotype 1 (1a, 1b) accounted for five of the six cases, and all patients with genotype 1 developed hepatitis. Severe liver injury occurred in two patients. Two deaths occurred, both of which were genotype 1 patients who had been given multiple boluses of corticosteroids in the first posttransplant year. No definite relationship between viral load in the donor and recipient outcome was found., Conclusion.  Transmission of HCV infection from cardiac donors who are viremic at the time of organ donation occurs with high frequency and can cause severe hepatitis. Hearts from infected patients should probably be restricted to those recipients who already have evidence for hepatitis C or are in need of emergent transplantation., (C) 2003 Lippincott Williams & Wilkins, Inc.1 aFile, Elizabeth1 aMehra, Mandeep1 aNair, Satheesh1 aDumas-Hicks, Debbie1 aPerrillo, Robert  uhttps://www.notifylibrary.org/reference/4018