Outcome of de novo hepatitis C virus infection in heart transplant recipients

The outcome of de novo hepatitis C virus (HCV) infection in heart transplan t recipients of HCV-antibody positive organs is not known. The aim of the s tudy was to determine the short-term outcome of de novo HCV infection in re cipients of HCV-positive donor organs. HCV-antibody negative recipients of HCV-antibody positive hearts were identified from January 1, 1991 to Februa ry 28, 1998. Control patients matched for year of transplantation were also identified. Twenty-eight patients (22 males, mean age of 56 +/- 11 SD) rec eived hearts from HCV-antibody-positive donors. The control group was simil ar to the patients in all clinical and demographic aspects. Twenty-three pa tients had detectable viremia by reverse-transcription polymerase chain rea ction (RT-PCR). Of these 23 patients with de novo HCV infection, 7 (30%) de veloped HCV-related liver disease. Three patients (13%) had chronic hepatit is and 4 patients (17%) developed severe acute cholestatic hepatitis (ACH), Mycophenolate mofetil (MMF) use (P = .04) and high viral load at onset of acute liver disease (P = .02) were associated with AGH. Overall survival wa s similar between patients with de novo HCV infection and controls (P = .20 ). Development of ACH (P = .02) and MMF use (P = .0009) were associated wit h decreased survival in patients with de novo HCV infection. The present st udy showed that survival of patients with de novo HCV infection was similar tot a matched control group. HCV-related severe ACH is associated with a p oor short-term outcome in patients with de novo HCV infection. MMF use may be associated with a higher incidence of HCV-related severe ACH and a poor short-term outcome.