Document 0380
 DOCN  M9550380
 TI    Transmission of the hepatitis-C virus by tissue transplantation.
 DT    9505
 AU    Conrad EU; Gretch DR; Obermeyer KR; Moogk MS; Sayers M; Wilson JJ;
       Strong DM; Northwest Tissue Center/Puget Sound Blood Center, Seattle,;
       Washington.
 SO    J Bone Joint Surg Am. 1995 Feb;77(2):214-24. Unique Identifier :
       AIDSLINE MED/95146514
 AB    The hepatitis-C virus has been the most prevalent cause of chronic
       hepatitis in both blood and organ recipients. The introduction of a
       second-generation immunoassay for antibodies to the hepatitis-C virus
       (HCV 2.0) provided the opportunity to determine if the hepatitis-C virus
       can be transmitted through tissue transplantation. Banked sera from
       tissue donors that had previously been found to be non-reactive to the
       first-generation hepatitis-C virus antibody assay (HCV 1.0) and
       non-reactive for antibodies to hepatitis-B core antigen were retested
       with HCV 2.0. The sera from two donors were reactive; the transplant
       records of recipients of tissues from these donors were reviewed, and
       the surgeons or hospitals were contacted. The tissue recipients were
       tested with HCV 2.0, and positive sera were tested for hepatitis-C virus
       RNA by polymerase chain reaction. Viral nucleic acids isolated from
       viremic donors and recipients were analyzed for identity by sequencing
       of the hepatitis-C virus envelope gene (E2) hypervariable region. There
       were twenty-one grafts, which had been treated with gamma radiation,
       from one donor; thirteen had been transplanted to twelve recipients.
       Serum samples from six of the recipients were tested; one was reactive.
       This patient had other risk factors for infection with the hepatitis-C
       virus, and sequence analysis demonstrated non-identity between the donor
       and recipient hepatitis-C virus isolates. Nine of twelve grafts from a
       second donor had been transplanted in nine recipients. Serum samples
       from five patients were tested with HCV 2.0; four were reactive. In
       three of the four patients, the sera were determined to be positive for
       the hepatitis-C virus by polymerase chain reaction. E2 sequence analyses
       of hepatitis-C virus RNA isolates from two of these recipients
       demonstrated sequence identity with the donor isolate. The results of
       the present report demonstrate that the hepatitis-C virus can be
       transmitted by bone, ligament, and tendon allografts. They also support
       the need for testing of all tissue donors for antibodies to the
       hepatitis-C virus before the tissue is released for transplantation. The
       results also suggest that seventeen kilo-gray of gamma radiation may
       inactivate the hepatitis-C virus in tissue.
 DE    Adolescence  Adult  Aged  Amino Acid Sequence  Base Sequence  Bone
       Transplantation/*ADVERSE EFFECTS  Contact Tracing  DNA, Viral/ANALYSIS
       Female  Gamma Rays  Genes, env  Hepatitis Antibodies/BLOOD  Hepatitis
       C/IMMUNOLOGY/*TRANSMISSION  *Hepatitis C Viruses/ISOLATION &
       PURIF/RADIATION EFFECTS  Human  Immunoblotting  Immunoenzyme Techniques
       Male  Middle Age  Molecular Sequence Data  Polymerase Chain Reaction
       Retrospective Studies  Sequence Analysis, DNA  Tendons/TRANSPLANTATION
       Tissue Transplantation/*ADVERSE EFFECTS  Viral Envelope
       Proteins/CHEMISTRY/GENETICS  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).