RECURRENCE OF HCV INFECTION IN A PATIENT (HCV AB+, RNA-) AFTER RECEIVING A LUNG TRANSPLANT FROM A DONOR WITH CHRONIC HCV INFECTION

Y Dahlan, A Taskinen, D Lien and M Ma

University of Alberta, Edmonton, Alberta

BACKGROUND: Little information is available concerning HCV infection and recipients of lung transplant. The majority of the lung transplant programs will consider HCV positive patients for lung transplantation. Very few lung transplant programs will use lung grafts from HCV sero-positive donors, except for recipients with active HCV infection. We report a case of recurrence of HCV infection in a patient who was HCV antibody positive and HCV RNA PCR negative after receiving lung grafts from a donor with active HCV infection.
CASE: A 35 year-old female had developed end-stage lung disease secondary to granulomatous talcosis of the lungs from previous intravenous drug use. Her liver enzymes were persistently normal and hepatic function was normal. The HCV antibody test was positive. However, the HCV RNA PCR tests had been negative. Clinically she did not have any evidence of chronic liver disease. She received a double lung transplant from a donor with chronic HCV infection. Post-lung transplant, her liver enzymes have remained normal. On surveillance, her HCV RNA test has become positive. There is no clinical evidence of hepatitis and the patient seems to tolerate the recurrence of infection quite well even though her immune status has been suppressed to prevent graft rejection. This case provides some information in the use of HCV infected lung grafts in the patients who have been exposed to HCV but do not have chronic HCV infection.