Reverse transcriptase polymerase chain reaction fails to detect peripheral-blood hepatitis C RNA in formalin-fixed liver tissue

Currently, one of the major indications for liver transplantation is infect ion with hepatitis C virus (HCV), Many studies have suggested that recurren t infection with HCV is universal after transplantation, Fastidious techniq ues, such as reverse transcriptase-polymerase chain reaction (RT-PCR), have proved to be highly sensitive for detecting HCV RNA in serum and in fresh- frozen and formalin-fixed paraffin-embedded (FFPE) liver tissue, In this st udy, we wanted to determine whether the identification of HCV RNA in liver tissue by RT-PCR might reflect the detection of circulating HCV RNA in bloo d within the tissue, rather than implying true tissue infection, We perform ed RT-PCR for HCV RNA in FFPE liver biopsy specimens taken from 14 donor al lografts shortly before and immediately after implantation into recipients, The recipients were known to have HCV RNA in serum and explanted liver tis sue, as determined by RT-PCR, We were unable to detect HCV RNA in any of th e study samples, either before or after transplantation, in a related study , qualitative and quantitative HCV RNA analyses were performed by RT-PCR an d branched DNA (bDNA) amplification, respectively, on serum samples collect ed pretransplantation and immediately posttransplantation from 10 other pat ients who underwent transplantation for hepatitis C, HCV RNA was detected i n all serum samples before and after transplantation by RT-PCR; however, th e bDNA assay detected HCV RNA in only 6 of 10 samples pre-orthotopic liver transplantation (OLT) and in none of the immediately post-OLT samples, In o ur system, despite the RT-PCR detection of HCV RNA in serum before and afte r the transplantation, HCV RNA is not detectable in the peripheral blood th at accompanies formalin-fixed liver tissue, This implies that RT-PCR detect ion of HCV RNA in tissue reflects true liver infection, Father than contami nation by HCV RNA in accompanying peripheral blood, (C) 1998 by the America n Association for the Study of Liver Diseases.