False‐Positive Hepatitis C Virus Serology Following HeartMate 3 Left Ventricular Assist Device Implantation

Authors:
Publisher website
Google Scholar
Abstract
Background: False‐positive hepatitis C virus (HCV) (FPHC) serology has been reported with earlier‐generation axial‐flow left ventricular assist devices (LVADs), but its frequency with the magnetically levitated HeartMate 3 and its implications for heart transplant pathways remain unknown. This study describes FPHC serology in HeartMate 3 LVAD recipients and explores associated clinical and immunological features. Methods: A retrospective, single‐center study was conducted at a specialist cardiothoracic center. All adults implanted with a HeartMate 3 LVAD between March 2018 and July 2025 with complete HCV serology before and after implantation were included. Patients developing HCV antibody positivity with negative confirmatory testing were classified as having FPHC serology. Patient demographics, blood product transfusions, liver function tests, lactate dehydrogenase, and human leukocyte antigen (HLA) sensitization were compared between groups. Results: Among 54 HeartMate 3 LVAD recipients, 10 (18.5%) developed FPHC serology after implantation. There were no significant differences between groups in age, sex, liver function tests, or lactate dehydrogenase. The number of fresh frozen plasma units transfused at implantation and the development of anti‐HLA Class I antibodies were associated with FPHC serology ( p = 0.039, p = 0.04, respectively). No significant associations were observed with red blood cell or platelet transfusions. Conclusion: FPHC serology is a clinically important phenomenon in HeartMate 3 LVAD recipients. Clinicians and patients should be aware of this phenomenon to minimize unnecessary investigations and delays to transplant candidacy assessment. Standardized confirmatory testing protocols and multicenter studies are needed to clarify the underlying immune mechanisms and their impact on post‐transplant outcomes.

This publication has 22 references indexed in Scilit: