Transmission of Hepatitis C Virus to Several Organ and Tissue Recipients from an Antibody-Negative Donor

through tissue transplantation has been rarely reported, a donor with undetected viremia may infect several recipients. A patient developed acute hepatitis C shortly after tissue transplantation. Ninety-one tissues or organs had been recovered from the donor. Objective: To determine whether the donor was the source of infection and the extent of transmission to other organ and tissue recipients. Design: Descriptive epidemiologic study; serum testing for HCV infection. Setting: Recipients were located in 16 states and 2 other coun-tries. Participants: Donor and graft recipients. Measurements: Hepatitis C virus infection was defined as the presence of anti-HCV or HCV RNA. The authors determined the genetic relatedness of viral isolates from the donor and recipients by genotype comparison and quasi-species analysis. Results: The donor was anti-HCV–negative but was HCV RNA– positive (genotype 1a). Forty persons received transplants during 22 months. Five persons were HCV-infected before transplanta-tion or had a genotype other than 1a, and 5 persons had no post-transplantation serum specimens available. Of the remainin