BACKGROUND: Given the shortage of suitable donor hearts for cardiac transplantation, and the favorable safety and efficacy of current agents used to treat hepatitis C virus (HCV), our institution recently piloted transplantation of select patients using HCV-positive donors. METHODS: Between September 2016 and March 2017, 12 HCV-naive patients and 1 patient with a history of treated HCV underwent heart transplantation (HT) using hearts from HCV-positive donors after informed consent. Patients who acquired HCV were referred to hepatology and treated with direct-acting anti-viral therapies (DAAs). Data collection and analysis were performed with institutional review board approval. RESULTS: At the time of HT, mean age of recipients was 53 ± 10 years, and 8 patients (61.5%) were on left ventricular assist device support. After consent to consider an HCV-positive heart, mean time to HT was 11 ± 12 days. Nine of 13 patients (69%) developed HCV viremia after transplant, including 8 who completed DAA treatment and demonstrated cure, as defined by a sustained virologic response 12 weeks after treatment. One patient died during Week 7 of his treatment due to pulmonary embolism. DAAs were well tolerated in all treated patients. CONCLUSIONS: In the era of highly effective DAAs, the use of HCV-positive donors represents a potential approach to safely expand the donor pool. Additional follow-up is needed to elucidate long-term outcomes.
BACKGROUND: Given the shortage of suitable donor hearts for cardiac transplantation, and the favorable safety and efficacy of current agents used to treat hepatitis C virus (HCV), our institution recently piloted transplantation of select patients using HCV-positive donors. METHODS: Between September 2016 and March 2017, 12 HCV-naive patients and 1 patient with a history of treated HCV underwent heart transplantation (HT) using hearts from HCV-positive donors after informed consent. Patients who acquired HCV were referred to hepatology and treated with direct-acting anti-viral therapies (DAAs). Data collection and analysis were performed with institutional review board approval. RESULTS: At the time of HT, mean age of recipients was 53 ± 10 years, and 8 patients (61.5%) were on left ventricular assist device support. After consent to consider an HCV-positive heart, mean time to HT was 11 ± 12 days. Nine of 13 patients (69%) developed HCV viremia after transplant, including 8 who completed DAA treatment and demonstrated cure, as defined by a sustained virologic response 12 weeks after treatment. One patientdied during Week 7 of his treatment due to pulmonary embolism. DAAs were well tolerated in all treated patients. CONCLUSIONS: In the era of highly effective DAAs, the use of HCV-positive donors represents a potential approach to safely expand the donor pool. Additional follow-up is needed to elucidate long-term outcomes.
Authors: Muhammad N Zahid; Shuyi Wang; Gerald H Learn; Peter L Abt; Emily A Blumberg; Peter P Reese; David S Goldberg; George M Shaw; Katharine J Bar Journal: J Clin Invest Date: 2019-05-21 Impact factor: 14.808
Authors: Peng-Sheng Ting; James Peter Hamilton; Ahmet Gurakar; Nathalie H Urrunaga; Michelle Ma; Jaime Glorioso; Elizabeth King; Lindsey P Toman; Russell Wesson; Jacqueline Garonzik-Wang; Shane Ottmann; Benjamin Philosophe; Mark Sulkowski; Andrew M Cameron; Christine M Durand; Po-Hung Chen Journal: Transpl Infect Dis Date: 2019-10-30 Impact factor: 2.228
Authors: Vishnu S Potluri; David S Goldberg; Sumit Mohan; Roy D Bloom; Deirdre Sawinski; Peter L Abt; Emily A Blumberg; Chirag R Parikh; James Sharpe; K Rajender Reddy; Miklos Z Molnar; Meghan Sise; Peter P Reese Journal: J Am Soc Nephrol Date: 2019-09-12 Impact factor: 10.121
Authors: Meghan E Sise; Ian A Strohbehn; Emily Bethea; Jenna L Gustafson; Raymond T Chung Journal: Curr Opin Organ Transplant Date: 2019-06 Impact factor: 2.640