Should Hepatitis C Donors Be Used in Naïve Urgent Status Patients on the Heart Transplant Waitlist?
Purpose of Review
The aim of this commentary is to review contemporary data on the use of hearts from hepatitis C positive donors.
There continues to be a critical shortage of suitable heart donors available for patients with advanced heart failure requiring transplantation. Historically, donors with chronic hepatitis C virus were not utilized for heart transplantation due to concern about poor post-transplant outcomes. This was due, in part, to concerns about successfully treating chronic hepatitis C after transmitting the infection from donor to recipient. The availability of direct-acting anti-viral therapies is changing this paradigm. These therapies are generally well-tolerated and have excellent rates of viral clearance.
We believe that heart donors with chronic hepatitis C should be routinely utilized for patients listed for urgent heart transplantation.
KeywordsHeart transplantation Hepatitis C Organ donation Patient selection Advanced heart failure
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 1.Colvin M, Smith JM, Skeans MA, Edwards LB, Uccellini K, Snyder JJ, Israni AK and Kasiske BL. OPTN/SRTR 2015 annual data report: heart. Am J Transplant Off J Am Soc Transplant Am Soc Transplant Surg 2017;17 Suppl 1:286–356.Google Scholar
- 7.• Grinstein J, Lourenco LM, Te HS, Renz JF, Jeevanandam V, Uriel N. Accepting hearts from hepatitis C-positive donor: can we expand the donor pool? J Card Fail. 2017;23:762–4 This case report was one of the first to describe the use of ledipasvir-sofosbuvir to successfully treat hepatitis C after a combined heart and liver transplantation. PubMedPubMedCentralCrossRefGoogle Scholar
- 9.• Schlendorf KH, Zalawadiya S, Shah AS, Wigger M, Chung CY, Smith S, et al. Early outcomes using hepatitis C-positive donors for cardiac transplantation in the era of effective direct-acting anti-viral therapies. J Heart Lung Transplant. 2018;37:763–9 This is the largest study to date describing the use of HCV-positive donor hearts for HCV-negative patients followed by direct-acting anti-viral therapies. PubMedCrossRefGoogle Scholar