Transmission of Hepatitis E Virus With Plasma Exchange in Kidney Transplant Recipients

Autor: Vincent Mallet, Stanislas Pol, Alix Portal, Jacques Izopet, Christophe Legendre, Bénédicte Deau, Marie-Laure Chaix, Anne-Marie Roque-Afonso, L. Hauser, Anaïs Vallet-Pichard, Anne Mercadier, Rebecca Sberro-Soussan, A. Beyloune
Rok vydání: 2018
Předmět:
Male
Blood transfusion
viruses
medicine.medical_treatment
030204 cardiovascular system & hematology
medicine.disease_cause
Gastroenterology
0302 clinical medicine
Hepatitis E virus
Risk Factors
Longitudinal Studies
Phylogeny
Kidney transplantation
Plasma Exchange
biology
virus diseases
Immunosuppression
Middle Aged
Hepatitis E
RNA
Viral
Female
030211 gastroenterology & hepatology
Antibody
Adult
medicine.medical_specialty
03 medical and health sciences
Internal medicine
medicine
Humans
Blood Transfusion
Hepatitis Antibodies
Risk factor
Transaminases
Aged
Retrospective Studies
Immunosuppression Therapy
Transplantation
business.industry
Retrospective cohort study
Sequence Analysis
DNA
medicine.disease
Kidney Transplantation
Transplant Recipients
digestive system diseases
Cross-Sectional Studies
Immunoglobulin M
Immunoglobulin G
biology.protein
Kidney Failure
Chronic
business
Zdroj: Transplantation. 102:1351-1357
ISSN: 0041-1337
DOI: 10.1097/tp.0000000000002185
Popis: Background After observing a case of plasma exchange-mediated hepatitis E virus (HEV) infection in a kidney transplant recipient, we investigated the relationship between plasma exchange and HEV infection after kidney transplantation. Methods A cohort of 263 patients who underwent kidney transplantation from January 1, 2011, through December 31, 2012, was screened for HEV markers, including anti-HEV IgG and IgM antibodies and HEV ribonucleic acid (RNA), on 3 consecutive blood samples: 1 before, 1 with a mean (standard deviation) of 9.5 (9) months, and 1 with a mean (standard deviation) of 18.2 (6.6) months after transplantation, respectively. Transfusional investigation was performed in patients with detectable HEV RNA. We explored the relationships between plasma exchange, posttransplantation transaminase elevation and HEV markers acquisition. Results Overall, 24 (9.1%) patients had acquired HEV markers on the first posttransplantation sample, including 2 patients with detectable HEV RNA, and 7 (2.3%) patients had long-term persistent HEV markers on the second posttransplantation sample, including 3 patients with detectable HEV RNA without detectable anti-HEV antibodies. Plasma exchange was an independent risk factor for the acquisition of posttransplantation and long-term persistent HEV markers. Pathogen-reduced plasma-borne transmission of HEV was demonstrated. Plasma exchange and long-term persistent HEV markers were risk factors of posttransplantation transaminase elevation. Conclusions Plasma exchange, including with pathogen-reduced plasma, is a risk factor for posttransplantation HEV infection and transaminase elevation. Screening for HEV RNA should be carried out in kidney transplant recipients treated with plasma exchange.
Databáze: OpenAIRE
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