These events cannot be classified as confirmed previous infections because (i) RNA negativity and the absence of anti-HEV IgM testing preclude establishing timing/acuity; (ii) passive transfer of anti-HEV antibodies via transfused blood products remains plausible post-transplant; (iii) donor HEV serology/RNA were unavailable; and (iv) given infrequent sampling and batch testing, transient viremia cannot be excluded. Here, CD40LG is linked to infection.