Why the study?
Heart transplantation donor pool scarcity persists despite rising end-stage refractory heart failure, while long-term outcomes and the impact of specific HCV genotypes following transplantation from HCV-positive donors remain to be seen.
Does heart transplantation from HCV-positive donors followed by direct-acting antivirals provide comparable outcomes to HCV-negative donors in patients with end-stage heart failure?
Does heart transplantation from HCV-positive donors followed by direct-acting antivirals provide comparable outcomes to HCV-negative donors in patients with end-stage heart failure?
Utilizing hearts from HCV-positive donors safely expands the donor pool, reduces waitlist time, and lowers waitlist mortality, with short-term outcomes comparable to HCV-negative donors when managed with direct-acting antivirals.
Supports expanded HCV donor use amid shortage; leaves open long-term validation in prospective trials.
Significant scarcity of a donor pool exists for heart transplantation (HT) as the prevalence of patients with end-stage refractory heart failure is increasing exceptionally. With the discovery of effective direct-acting antiviral and favorable short-term outcomes following HT, the hearts from hepatitis C virus (HCV) patient are being utilized to increase the donor pool. Short-term outcomes with regards to graft function, coronary artery vasculopathy, and kidney and liver disease is comparable in HCV-negative recipients undergoing HT from HCV-positive donors compared to HCV-negative donors. A significant high incidence of donor-derived HCV transmission was observed with great success of achieving sustained viral response with the use of direct-acting antivirals. By accepting HCV-positive organs, the donor pool has expanded with younger donors, a shorter waitlist time, and a reduction in waitlist mortality. However, the long-term outcomes and impact of specific HCV genotypes remains to be seen. We reviewed the current literature on HT from HCV-positive donors.
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Patel et al. (2022) studied this question.
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