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• W2085406061 abstract "During a pretransplantation evaluation of a potential living kidney donor, we noted mild elevations in transaminase levels (alanine aminotransferase, 44 U/L; aspartate aminotransferase, 48 U/L). Further testing included a liver ultrasound and viral hepatitis workup that tested for hepatitis C virus (HCV) antibody, hepatitis B surface antigen, and hepatitis B core antibody. The ultrasonography results were normal, and testing for hepatitis produced negative results. Due to persistently elevated transaminase levels, we decided to check the donor's HCV RNA although test results for HCV antibody were negative. HCV RNA was detectable, which led to a diagnosis of window-period acute HCV infection. The individual was advised against donation. Three months later, an HCV antibody test returned positive results, confirming the diagnosis of acute HCV infection.1Maheshwari A. Ray S. Thuluvath P.J. Acute hepatitis C.Lancet. 2008; 372: 321-332Abstract Full Text Full Text PDF PubMed Scopus (201) Google Scholar This case illustrates the importance of using nucleic acid testing to screen donors for HCV. It is well recognized that no single test can detect all infections reliably due to factors such as false-negative results during a window period or assay-related issues.1Maheshwari A. Ray S. Thuluvath P.J. Acute hepatitis C.Lancet. 2008; 372: 321-332Abstract Full Text Full Text PDF PubMed Scopus (201) Google Scholar Thus, a combination of serologic and nucleic acid tests increases the sensitivity of screening donors for HCV. Recently, the US Public Health Service updated its guidelines to include recommending the use of nucleic acid testing for HCV screening of potential donors2PHS guideline for reducing transmission of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) through solid organ transplantation.Public Health Rep. 2013; 128 (Accessed December 9, 2013): 1-97http://www.regulations.govGoogle Scholar; however, the US Organ Procurement Organization policies still recommend serologic testing only.3Health Resources and Services AdministrationMinimum procurement standards for an organ procurement organization (OPO). Health Resources and Services Administration, Rockville, MD2011http://optn.transplant.hrsa.gov/policiesandbylaws2/policies/pdfs/policy_2.pdfGoogle Scholar Furthermore, there are no clear universal society guidelines worldwide or for many emerging countries, including India and China, where half the world's population resides and which are experiencing an exponential increase in the number of kidney transplantations.4Chugh K.S. Five decades of Indian nephrology: a personal journey.Am J Kidney Dis. 2009; 54: 753-763Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar We propose that nephrology, hepatology, and public health societies develop a consensus statement on this issue so that standardized transplantation care can be provided worldwide and the risk of HCV transmission can be minimized.5Centers for Disease Control (CDC) and PreventionTransmission of hepatitis C virus through transplanted organs and tissue–Kentucky and Massachusetts, 2011.MMWR Morbid Mortal Wkly Rep. 2011; 60: 1697-1700PubMed Google Scholar Financial Support: The authors declare that they have no relevant financial interests." @default.
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• W2085406061 date "2014-03-01" @default.
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• W2085406061 title "Nucleic Acid Testing to Screen Potential Kidney Donors for Hepatitis C Virus: Is a Universal Statement Possible Soon?" @default.
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• W2085406061 doi "https://doi.org/10.1053/j.ajkd.2013.11.020" @default.
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