Key result
HeartMate 3 LVAD implantation is linked to false-positive HCV serology in ~19% of recipients.
Why the study?
False-positive HCV serology has been reported with earlier-generation axial-flow LVADs, but its frequency with the magnetically levitated HeartMate 3 and its implications for heart transplant pathways remained unknown.
What is the frequency of false-positive hepatitis C virus serology and its associated clinical and immunological features in adults undergoing HeartMate 3 left ventricular assist device implantation?
Cohort (n=54)
No
What is the frequency of false-positive hepatitis C virus serology and its associated clinical and immunological features in adults undergoing HeartMate 3 left ventricular assist device implantation?
Nearly one in five HeartMate 3 LVAD recipients develop false-positive HCV serology—linked to fresh frozen plasma transfusion and HLA Class I sensitization—highlighting the need for standardized confirmatory testing to prevent delays in heart transplant listing.
Answers are grounded in this paper and cite their sources.
May necessitate confirmatory HCV testing post-HeartMate 3 LVAD; extends prior observations from axial-flow devices.
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.
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Im* et al. (2026) conducted a cohort in HeartMate 3 left ventricular assist device implantation (n=54). HeartMate 3 left ventricular assist device implantation was evaluated on False-positive hepatitis C virus (FPHC) serology (HCV antibody positivity with negative confirmatory testing). HeartMate 3 LVAD implantation resulted in false-positive hepatitis C virus serology in 18.5% (10/54) of recipients, associated with fresh frozen plasma transfusions (p=0.039) and anti-HLA Class I antibodies (p=0.04).
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