Clinical outcomes of heart transplantation using hepatitis c-viremic donors: A systematic review with meta-analysis

Villegas-Galaviz, Josue; Anderson, Eve; Guglin, Maya

doi:10.1016/j.healun.2022.01.010

Cited by 6 publications

(8 citation statements)

References 30 publications

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“…As with kidneys, both HCVþ livers and hearts are increasingly transplanted into HCV-recipients with excellent short-term outcomes [91][92][93][94]; long-term survival requires further study. Among HCVþ liver donors, a recent registry analysis found evidence of underutilization, despite excellent 1-year graft survival [95 & ].…”

Section: Other Viremic or Elevated Disease Transmission Risk Donorsmentioning

confidence: 99%

Beyond donation to organ utilization in the USA

Stewart

Lonze

2023

Current Opinion in Organ Transplantation

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Purpose of reviewThe deceased donor organ pool has broadened beyond young, otherwise healthy head trauma victims. But an abundance of donated organs only benefits patients if they are accepted, expeditiously transported and actually transplanted. This review focuses on postdonation challenges and opportunities to increase the number of transplants through improved organ utilization. Recent findingsWe build upon recently proposed changes in terminology for measuring organ utilization. Among organs recovered for transplant, the nonuse rate (NUR REC ) has risen above 25% for kidneys and pancreata. Among donors, the nonuse rate (NUR DON ) has risen to 40% for livers and exceeds 70% for thoracic organs. Programme-level variation in offer acceptance rates vastly exceeds variation in the traditional, 1-year survival benchmark. Key opportunities to boost utilization include donation after circulatory death and hepatitis C virus (HCV)þ organs; acute kidney injury and suboptimal biopsy kidneys; older and steatotic livers.

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Section: Other Viremic or Elevated Disease Transmission Risk Donorsmentioning

confidence: 99%

Beyond donation to organ utilization in the USA

Stewart

Lonze

2023

Current Opinion in Organ Transplantation

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“…Additional data from published experience is summarized elsewhere. [50][51][52][53] Reported short-term outcomes after D+/R-heart transplantation have invariably been excellent. A note of caution springs from the lack of long-term outcome data, and the potential negative impact of early viremia on the development of acute or chronic graft rejection, CAV, fibrosing cholestatic hepatitis, and other complications.…”

Section: Experience and Outcomesmentioning

confidence: 99%

“…66 Initiation of DAASs within 1-2 weeks posttransplant is favored to maximize treatment response while minimizing HCV-related complications. 53,72…”

Section: Timing Of Hcv Treatment In D+/r-heart Transplantmentioning

confidence: 99%

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Hepatitis C and heart transplantation: An update

Nunez,

Kelkar

2023

Clinical Transplantation

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There are limited data regarding heart transplantation in the setting of hepatitis C virus (HCV) infection in either recipients or donors, as the practice was infrequent, given concerns of worse post‐transplant outcomes. This changed dramatically after the development of highly effective HCV therapies, namely direct‐acting antivirals (DAAs). Additionally, nucleic acid testing currently in use establishes more precisely the risk of HCV transmission from donors. As a result, chronic HCV infection in itself is no longer a barrier for heart transplant candidates, and the use of HCV‐positive organs for HCV‐infected and non‐infected transplant candidates has increased dramatically. A review of the literature revealed that in the pre‐DAA era, HCV seropositive heart transplant patients had a higher mortality than their seronegative counterparts. However, short‐term data suggest that the differences in survival have been erased in the DAA era. Heart transplantation from HCV‐viremic donors to HCV‐uninfected recipients has become increasingly common as the number of deceased donors with HCV viremia has increased over the past years. Preliminary outcome reports are very encouraging, although further data are needed with regard to long‐term safety. New information continues to be incorporated to optimize protocols that guide this practice.

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“…Despite that, the goal of improved geographic sharing of organs, reducing waitlist time, and better stratification of the most medically urgent patients appears to have been achieved. [1][2][3] The opioid epidemic has led to an expanded donor pool, 4 and additional expansion has occurred with the development of protocols for the use of hepatitis C positive organs 5 and donation after cardiac death (DCD) hearts. 6 Yet, organ preservation still remains a major issue limiting supply and geographic reach of donor hearts, and innovative technologies are emerging to address this issue.…”

mentioning

confidence: 99%