TY - JOUR
T1 - Trends and three-year outcomes of hepatitis C virus–viremic donor heart transplant for hepatitis C virus–seronegative recipients
AU - Ruck, Jessica M.
AU - Zhou, Alice L.
AU - Zeiser, Laura B.
AU - Alejo, Diane
AU - Durand, Christine M.
AU - Massie, Allan B.
AU - Segev, Dorry L.
AU - Bush, Errol L.
AU - Kilic, Ahmet
N1 - Funding Information:
This work was supported by grant number F32-AG067642091A1 (Dr Ruck) from the National Institute of Aging (NIA) and K24-AI144954-08 (Dr Segev) from the National Institute of Allergy and Infectious Disease (NIAID). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the US Government.
Funding Information:
This work was supported by grant number F32-AG067642091A1 (Dr Ruck) from the National Institute of Aging (NIA) and K24-AI144954-08 (Dr Segev) from the National Institute of Allergy and Infectious Disease (NIAID). The analyses described here are the responsibility of the authors alone and do not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products or organizations imply endorsement by the US Government.
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/12
Y1 - 2022/12
N2 - Objective: Heart transplants (HTs) from hepatitis C virus (HCV)-viremic donors to HCV-seronegative recipients (HCV D+/R–) have good 6-month outcomes, but practice uptake and long-term outcomes overall and among candidates on mechanical circulatory support (MCS) have yet to be established. Methods: Using the Scientific Registry of Transplant Recipients, we identified US adult HCV-seronegative HT recipients (R–) from 2015 to 2021. We classified donors as HCV-seronegative (D–) or HCV-viremic (D+). We used multivariable regression to compare post-HT extracorporeal membranous oxygenation, dialysis, pacemaker, acute rejection, and risk of post-HT mortality between HCV D+/R– and HCV D–/R–. Models were adjusted for donor, recipient, and transplant characteristics and center HT volume. We performed subgroup analyses of recipients bridged with MCS. Results: From 2015 to 2021, the number of HCV D+/R– HT increased from 1 to 181 and the number of centers performing HCV D+/R– HT increased from 1 to 60. Compared with HCV D–/R– recipients, HCV D+/R– versus D–/R– recipients overall and among patients bridged with MCS had similar odds of post-HT extracorporeal membranous oxygenation, dialysis, pacemaker, and acute rejection; and mortality risk at 30 days, 1 year, and 3 years (all P >. 05). High center HT volume but not HCV D+/R– volume (<5 vs >5 in any year) was associated with lower mortality for HCV D+/R– HT. Conclusions: HCV D+/R– and D–/R– HT have similar outcomes at 3 years’ posttransplant. These results underscore the opportunity provided by HCV D+/R– HT, including among the growing population bridged with MCS, and the potential benefit of further expanding use of HCV+ allografts.
AB - Objective: Heart transplants (HTs) from hepatitis C virus (HCV)-viremic donors to HCV-seronegative recipients (HCV D+/R–) have good 6-month outcomes, but practice uptake and long-term outcomes overall and among candidates on mechanical circulatory support (MCS) have yet to be established. Methods: Using the Scientific Registry of Transplant Recipients, we identified US adult HCV-seronegative HT recipients (R–) from 2015 to 2021. We classified donors as HCV-seronegative (D–) or HCV-viremic (D+). We used multivariable regression to compare post-HT extracorporeal membranous oxygenation, dialysis, pacemaker, acute rejection, and risk of post-HT mortality between HCV D+/R– and HCV D–/R–. Models were adjusted for donor, recipient, and transplant characteristics and center HT volume. We performed subgroup analyses of recipients bridged with MCS. Results: From 2015 to 2021, the number of HCV D+/R– HT increased from 1 to 181 and the number of centers performing HCV D+/R– HT increased from 1 to 60. Compared with HCV D–/R– recipients, HCV D+/R– versus D–/R– recipients overall and among patients bridged with MCS had similar odds of post-HT extracorporeal membranous oxygenation, dialysis, pacemaker, and acute rejection; and mortality risk at 30 days, 1 year, and 3 years (all P >. 05). High center HT volume but not HCV D+/R– volume (<5 vs >5 in any year) was associated with lower mortality for HCV D+/R– HT. Conclusions: HCV D+/R– and D–/R– HT have similar outcomes at 3 years’ posttransplant. These results underscore the opportunity provided by HCV D+/R– HT, including among the growing population bridged with MCS, and the potential benefit of further expanding use of HCV+ allografts.
KW - donor pool
KW - heart transplant
KW - hepatitis C
KW - outcomes
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U2 - 10.1016/j.xjon.2022.10.007
DO - 10.1016/j.xjon.2022.10.007
M3 - Article
C2 - 36590744
AN - SCOPUS:85143534805
SN - 2666-2736
VL - 12
SP - 269
EP - 279
JO - JTCVS Open
JF - JTCVS Open
ER -