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 i nfection with hepatitis C virus (HCV), Many studies have suggested tha t recurrent infection with HCV is universal after transplantation, Fas tidious techniques, such as reverse transcriptase-polymerase chain rea ction (RT-PCR), have proved to be highly sensitive for detecting HCV R NA in serum and in fresh-frozen and formalin-fixed paraffin-embedded ( FFPE) liver tissue, In this study, 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 blood within the tissue, rather th an implying true tissue infection, We performed RT-PCR for HCV RNA in FFPE liver biopsy specimens taken from 14 donor allografts shortly bef ore and immediately after implantation into recipients, The recipients were known to have HCV RNA in serum and explanted liver tissue, as de termined by RT-PCR, We were unable to detect HCV RNA in any of the stu dy samples, either before or after transplantation, in a related study , qualitative and quantitative HCV RNA analyses were performed by RT-P CR and branched DNA (bDNA) amplification, respectively, on serum sampl es collected pretransplantation and immediately posttransplantation fr om 10 other patients who underwent transplantation for hepatitis C, HC V RNA was detected in all serum samples before and after transplantati on by RT-PCR; however, the 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 our system, despite the RT-PCR detec tion of HCV RNA in serum before and after the transplantation, HCV RNA is not detectable in the peripheral blood that accompanies formalin-f ixed liver tissue, This implies that RT-PCR detection of HCV RNA in ti ssue reflects true liver infection, Father than contamination by HCV R NA in accompanying peripheral blood, (C) 1998 by the American Associat ion for the Study of Liver Diseases.