For organ recipients with donor-derived hepatitis B virus (HBV) or hepatitis C virus (HCV) infections, recognizing risk factors among organ donors may contribute to early diagnosis and treatment, according to results published in the American Journal of Transplantation.
The study included organ recipients with donor-derived HBV or HCV infections investigated by the US Centers for Disease Control and Prevention (CDC) from 2014 to 2017 in the United States. The researchers characterized new HBV infections in organ recipients if donors tested negative for total antiHBc, HBsAg, and HBV DNA, and they characterized new HCV infections in recipients if donors tested negative for antiHCV and HCV RNA. They collected data on donor risk behaviors based on next-of-kin interviews and medical records.
From 2014 to 2017, the researchers identified 7 new recipient HBV infections associated with 7 donors. Of these, 86% (n=6) of the recipients survived. At the last follow-up, all survivors had functioning grafts, and 83% (n=5) had started antiviral therapy.
The researchers identified 20 new recipient HCV infections associated with 9 donors. Of these, 95% (n=19) recipients survived. At the last follow-up, 95% (n=18) of survivors had functioning grafts, and 74% (n=14) had started antiviral treatment.
Using next-of-kin interviews and medical records, the researchers found that 69% (11/16) of donors showed evidence of injection drug use. All donors met Public Health Service increased risk donor criteria. When donors were identified as being an increased risk donor, recipients had earlier diagnosis of infection and prompt implementation of therapy.
“CDC will continue to work with governmental and other partners to evaluate current recommendations for donor risk factor criteria, designation, and nomenclature to enhance both safety and availability of organs,” the researchers wrote.
Bixler D, Annambholta P, Abara WE, et al. Hepatitis B and C virus infections transmitted through organ transplantation investigated by CDC, United States, 2014-2017 [published online March 12, 2019]. Am J Transplant. doi:10.1111/ajt.15352