Hepatitis C Donor Viremic Cardiac Transplantation: A Practical Approach.
Clin Transplant. 2019 Dec 12;:e13764
Authors: Morris KL, Adlam JP, Padanilam M, Patel A, Garcia-Cortes R, Chaudhry SP, Seasor E, Tompkins S, Hoefer C, Zanotti G, Walsh MN, Salerno C, Bochan M, Ravichandran A
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 (DAA), 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.
PMID: 31830339 [PubMed – as supplied by publisher]