Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jan;34(1):e13764.
doi: 10.1111/ctr.13764. Epub 2019 Dec 30.

Hepatitis C donor viremic cardiac transplantation: A practical approach

Kathleen L Morris  1 , James P Adlam  1 , Mathew Padanilam  1 , Amit Patel  1 , Rafael Garcia-Cortes  1 , Sunit-Preet Chaudhry  1 , Erica Seasor  1 , Shannon Tompkins  1 , Caitlin Hoefer  1 , Giorgio Zanotti  1 , Mary Norine Walsh  1 , Christopher Salerno  1 , Markian Bochan  2 , Ashwin Ravichandran  1
Affiliations

Hepatitis C donor viremic cardiac transplantation: A practical approach

Kathleen L Morris et al. Clin Transplant. 2020 Jan.

Abstract

Introduction: Patients with end-stage heart failure eligible for orthotopic heart transplantation (OHT) exceed the number of available donor organs. With highly effective hepatitis C virus (HCV) antiviral therapy now available, HCV+ organs are increasingly utilized. We seek to describe our experience with patients receiving HCV viremic organs as compared to non-HCV transplant recipients.

Methods: Our center began utilizing HCV hearts in February 2018. We retrospectively reviewed baseline demographics, laboratory data and outcomes for those undergoing OHT with majority being from a viremic HCV donor.

Results: Twenty-three of 25 HCV recipients received hearts from NAT+ donors with 22 of 23 seroconverting within 7 days. Fifteen recipients have completed HCV treatment, with the longest duration of follow-up being 13 months. No differences in rates of rejection, hospitalizations or death were seen between non-HCV and HCV transplant patients.

Discussion: With the advent of available direct-acting antivirals (DAAs), viremic HCV hearts provide an opportunity to increase organ availability. Moreover, treatment for HCV in the setting of immunosuppression is well-tolerated and results in sustained viremic response.

Conclusion: Viremic, discordant HCV OHT can be performed in a safe and effective manner utilizing a systematic, multidisciplinary approach without an effect on short-term outcomes.

Keywords: artificial organs/support devices: heart/ventricular assist devices; donors and donation; heart (allograft) function/dysfunction.

PubMed Disclaimer

References

REFERENCES

    1. Cowger JA. Addressing the growing U.S. donor heart shortage: Waiting for Godot or a transplant? JACC. 2017;69(13):1715-1717.
    1. File E, Mehra M, Nair S, et al. Allograft transmission of hepatitis C virus infection from infected donors in cardiac transplantation. Transplantation. 2003;76:1096-1100.
    1. Gasink LB, Blumberg EA, Localio AR, et al. Hepatitis C virus seropositivity in organ donors and survival in heart transplant recipients. JAMA. 2006;296:1843-1850.
    1. Feld JJ, Jacobson IM, Hezode C, et al. Sofosbuvir and velpatasvir for HCV genotypes 1,2,4,5, and 6 infection. N Engl J Med. 2015;373:2599-2607.
    1. Afdhal N, Zeuzem S, Kwo P, et al. Ledipasvir and Sofosbuvir for untreated HCV genotype 1 infection. N Eng J Med. 2014;370:1889-1897.

Substances

LinkOut - more resources