Liver TransplantationPretransplant anti-hepatitis C virus antibody and HCV-RNA-polymerase chain reaction as predictor of posttransplant liver dysfunction
Section snippets
Patients and methods
Of 1400 kidney recipients, 89 were randomly selected for this study. The patient with hepatitis B virus (HBV) infection or hepatic dysfunction due to cyclosporine (CyA) was excluded. The posttransplant HCV marker assay and the posttransplant liver function test were reviewed retrospectively. The pretransplant HCV marker assay was performed using patients’ frozen stored pretransplant serum. The anti-HCV antibody and HCV-RNA-PCR tests were performed simultaneously as an HCV marker assay. The
Pretransplant status of the HCV marker
The pretransplant HCV marker positive rates assessed by ELISA/3 and PCR was 20.2% (18 of 89) and 29.2% (26 of 89), respectively. The positive rates were different according to the types of HCV assay without statistical difference.
Serial change of HCV marker after transplant
After 30.8 months of mean follow-up, the positive rates assessed by ELISA/3 and PCR was 24.7% (22 of 89) and 33.7% (30 of 89), respectively. The positive rate of the posttransplant HCV marker was increased compared to that of the pretransplant marker. The results of
Discussion
The possibility of a false-negative result still remains,3 in spite of the high accuracy of the ELISA test.4 On the other hand, the PCR test has a remarkable false-positive rate that is mainly attributed to the contamination during the test. Therefore, it is popularly accepted that the combined interpretation of the ELISA and PCR tests is desirable for precise evaluation of HCV infection status.3 In our study, a significant disparity of results between ELISA/3 and PCR was present. These results
References (4)
- et al.
Gastroenterology
(1993) - et al.
Lancet
(1990)