Outcomes of Over 1000 Heart Transplants Using Hepatitis C–Positive Donors in the Modern Era

Kwon, Jennie H.; Hill, Morgan A.; Patel, Raj; Tedford, Ryan J.; Hashmi, Zubair A.; Shorbaji, Khaled; Huckaby, Lauren V.; Welch, Brett; Kilic, Arman

doi:10.1016/j.athoracsur.2022.11.002

Cited by 3 publications

(5 citation statements)

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“…demonstrated a significant reduction in waitlist time by utilizing HCV+ donor hearts (HCV+, 329 days vs. HCV negative, 78 days) 26,27 . The waiting days in the current study was comparable between groups which was shorter in HCV+ group in the previous studies 1,12 . The absence of difference in waiting time may have been related to the HCV+ group having more blood type O candidates than the HCV‐neg group 28,29 …”

Section: Discussionmentioning

confidence: 45%

“…26,27 The waiting days in the current study was comparable between groups which was shorter in HCV+ group in the previous studies. 1,12 The absence of difference in waiting time may have been related to the HCV+ group having more blood type O candidates than the HCV-neg group. 28,29 In the present study, ischemic time of donor hearts and travel distance were longer in HCV+ donors, which was similar to the prior results.…”

Section: Discussionmentioning

confidence: 99%

“…28,29 In the present study, ischemic time of donor hearts and travel distance were longer in HCV+ donors, which was similar to the prior results. 1,12 There may be secondary to the limited number of transplant centers using HCV-positive hearts, leading to a larger radius of travel for hearts that are otherwise turned down by centers closer to the donor hospital. 30,31 Despite this difference, the survival was comparable between two groups with ischemic time <4 h in each group.…”

Section: Discussionmentioning

confidence: 99%

“…Utilization of Hepatitis C Virus infected donors (HCV+) is one of the strategies to expand the donor pool and narrow the gap between the patients requiring organ transplants and the donors available to meet that demand. 1,2 An earlier study of the use of HCV+ in heart transplantation (HT) demonstrated inferior survival with the use of HCV+ donor hearts in the era of interferon-based therapy for HCV, which was likely driven by liver disease and coronary allograft vasculopathy. 3 Following the Food and Drug Administration approval of direct acting antivirals (DAA) in 2014 with cure rate of >90%-95%, [3][4][5] there has been an increase in utilization HCV+ donor hearts in line with the rise in donors who died of drug overdose.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Utilization of hepatitis C virus infected donors in heart transplant recipients with elevated MELD‐XI score

Hirani,

Okumura,

Isath

et al. 2023

Clinical Transplantation

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BackgroundThe advent of direct‐acting antivirals has helped to increase the safe utilization of organs from hepatitis C virus positive (HCV+) donors. However, the outcomes of heart transplantation (HT) using an HCV+ donor are unclear in recipients with underlying liver disease represented by an elevated model for end‐stage liver disease excluding international normalized ratio (MELD‐XI).MethodsThe United Network of Organ Sharing database was queried from Jan 2016 to Dec 2021. Post‐transplant outcomes stratified by recipient MELD‐XI score (low <10.37, medium, 10.38–13.39, and high >13.4) was compared between patients with HT from HCV+ (N = 792) and patients with HT from HCV‐negative donors (N = 15,266).ResultsThe median MELD‐XI score was comparable (HCV+, 12.1, vs. HCV‐negative, 11.8, p = .37). In the HCV+ group, donors were older (33 vs. 31 years, p < .001). Ischemic time of donor hearts (3.48 vs. 3.28 h, p < .001) and travel distance (250 vs. 157 miles, p < .001) were longer in HCV+ group. In the Kaplan Meier analysis with a median follow‐up of 750 days, survival was comparable between the two groups (2‐year survival, MELD‐XI Low: HCV+, 92.4 ± 3.6% vs. HCV‐negative, 91.1 ±.8%, p = .83, Medium: HCV+ 89.2 ± 4.3% vs. HCV‐negative, 88.2 ± 1.0%, p = .68, and High: HCV+, 84.9 ± 4.5% vs. HCV‐negative, 84.6 ± 1.1%, p = .75) In multivariate Cox hazard models, HCV donors were not associated with mortality in each MELD‐XI subgroup (Low: adjusted hazard ratio (aHR), 1.02, p = .94; Medium: aHR, .95, p = .81; and High: aHR, .93, p = .68).ConclusionUtilization of HCV+ hearts was not associated with an increased risk of adverse outcomes in recipients with an elevated MELD‐ XI score.

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Section: Discussionmentioning

confidence: 45%